TOPIRAMATE
topiramate 50 mg tablet, 60
TOPIRAMATE (8164Q)
8164Q
Body System:
Manner of administration:Oral
Restriction 17487
Indication: Seizures
Restriction 5325
Indication: Migraine
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 60 | # of repeats: 5 | DPMQ: $19.45 | Max safety net: $20.93 | General Patient Charge: $23.72 |
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