GABAPENTIN

gabapentin 100 mg capsule, 100

GABAPENTIN (8505P)

gabapentin 100 mg capsule, 100
8505P
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction  17445

Indication: Focal onset seizures
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 100 # of repeats: 5 DPMQ: $17.96 Max safety net: $19.44 General Patient Charge: $22.23
Available brands
APX-Gabapentin
GAPENTIN
Gabacor
Nupentin 100
Neurontin
*Additional charge for this brand is $2.20
 DPMQ: $20.16 Max safety net: $19.44 General Patient Charge: $24.43