EZETIMIBE (&) ROSUVASTATIN

ezetimibe 10 mg tablet [30] (&) rosuvastatin 40 mg tablet [30], 60
Manner of administration:Oral
General Schedule
No restrictions
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: $28.40 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Ezalo Composite Pack 10mg+40mg
Ezetimibe - Rosuvastatin Sandoz 10 mg/40 mg
Pharmacor Ezetimibe Rosuvastatin Composite Pack
Rosuzet Composite Pack
*Additional charge for this brand is $3.09
DPMQ: $31.49 Max safety net: $25.00 General Patient Charge: $28.09
ezetimibe 10 mg tablet [30] (&) rosuvastatin 40 mg tablet [30], 60
Manner of administration:Oral
General Schedule
Restricted Benefit

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: $43.02 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Ezalo Composite Pack 10mg+40mg
Ezetimibe - Rosuvastatin Sandoz 10 mg/40 mg
Pharmacor Ezetimibe Rosuvastatin Composite Pack
Rosuzet Composite Pack
*Additional charge for this brand is $6.18
DPMQ: $49.20 Max safety net: $25.00 General Patient Charge: $31.18