VERAPAMIL

VERAPAMIL (1241H)

verapamil hydrochloride 240 mg modified release tablet, 30
1241H
Body System:
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: 30 # of repeats: 5 DPMQ: $20.92 Max safety net: $22.40 General Patient Charge: $25.00
Available brands
Cordilox SR
Isoptin SR
*Additional charge for this brand is $3.50
 DPMQ: $24.42 Max safety net: $22.40 General Patient Charge: $28.50

VERAPAMIL (13408Q)

verapamil hydrochloride 240 mg modified release tablet, 30
13408Q
Body System:
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: 60 # of repeats: 5 DPMQ: $28.06 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Cordilox SR
Isoptin SR
*Additional charge for this brand is $7.00
 DPMQ: $35.06 Max safety net: $25.00 General Patient Charge: $32.00