EZETIMIBE (&) ROSUVASTATIN
ezetimibe 10 mg tablet [30] (&) rosuvastatin 20 mg tablet [30], 60
Manner of administration:Oral
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 1 | # of repeats: 5 | DPMQ: $28.84 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
|
|
|||||
|
|
|||||
|
|
|||||
|
|
DPMQ: $31.73 | Max safety net: $25.00 | General Patient Charge: $27.89 | ||
ezetimibe 10 mg tablet [30] (&) rosuvastatin 5 mg tablet [30], 60
Manner of administration:Oral
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 1 | # of repeats: 5 | DPMQ: $25.57 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
|
|
|||||
|
|
|||||
|
|
DPMQ: $28.36 | Max safety net: $25.00 | General Patient Charge: $27.79 | ||
ezetimibe 10 mg tablet [30] (&) rosuvastatin 40 mg tablet [30], 60
Manner of administration:Oral
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 1 | # of repeats: 5 | DPMQ: $28.53 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
|
|
|||||
|
|
|||||
|
|
|||||
|
|
DPMQ: $31.53 | Max safety net: $25.00 | General Patient Charge: $28.00 | ||
ezetimibe 10 mg tablet [30] (&) rosuvastatin 10 mg tablet [30], 60
Manner of administration:Oral
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 1 | # of repeats: 5 | DPMQ: $26.92 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
|
|
|||||
|
|
|||||
|
|
|||||
|
|
DPMQ: $29.81 | Max safety net: $25.00 | General Patient Charge: $27.89 | ||
ezetimibe 10 mg tablet [30] (&) rosuvastatin 20 mg tablet [30], 60
Manner of administration:Oral
Restriction
Indication: The condition must be stable for the prescriber to consider the listed maximum quantity
of this medicine suitable for this patient.
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 2 | # of repeats: 5 | DPMQ: $43.32 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
|
|
|||||
|
|
|||||
|
|
|||||
|
|
DPMQ: $49.10 | Max safety net: $25.00 | General Patient Charge: $30.78 | ||
ezetimibe 10 mg tablet [30] (&) rosuvastatin 40 mg tablet [30], 60
Manner of administration:Oral
Restriction
Indication: The condition must be stable for the prescriber to consider the listed maximum quantity
of this medicine suitable for this patient.
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 2 | # of repeats: 5 | DPMQ: $42.70 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
|
|
|||||
|
|
|||||
|
|
|||||
|
|
DPMQ: $48.70 | Max safety net: $25.00 | General Patient Charge: $31.00 | ||
ezetimibe 10 mg tablet [30] (&) rosuvastatin 10 mg tablet [30], 60
Manner of administration:Oral
Restriction
Indication: The condition must be stable for the prescriber to consider the listed maximum quantity
of this medicine suitable for this patient.
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 2 | # of repeats: 5 | DPMQ: $39.48 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
|
|
|||||
|
|
|||||
|
|
|||||
|
|
DPMQ: $45.26 | Max safety net: $25.00 | General Patient Charge: $30.78 | ||
ezetimibe 10 mg tablet [30] (&) rosuvastatin 5 mg tablet [30], 60
Manner of administration:Oral
Restriction
Indication: The condition must be stable for the prescriber to consider the listed maximum quantity
of this medicine suitable for this patient.
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 2 | # of repeats: 5 | DPMQ: $36.78 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
|
|
|||||
|
|
|||||
|
|
DPMQ: $42.36 | Max safety net: $25.00 | General Patient Charge: $30.58 | ||