BISOPROLOL

bisoprolol fumarate 10 mg tablet, 28

BISOPROLOL (8606Y)

bisoprolol fumarate 10 mg tablet, 28
8606Y
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Moderate to severe heart failure
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 28 # of repeats: 5 DPMQ: $18.52 Max safety net: $20.00 General Patient Charge: $22.79
Available brands
APO-Bisoprolol
BISOPROLOL-WGR
Bicard 10
Bisoprolol Sandoz
Bisoprolol generichealth
Bispro 10
Bicor
*Additional charge for this brand is $3.86
 DPMQ: $22.38 Max safety net: $20.00 General Patient Charge: $26.65