BISOPROLOL

BISOPROLOL (13419G)

bisoprolol fumarate 2.5 mg tablet, 28
13419G
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: 2 Max qty units: 56 # of repeats: 5 DPMQ: $22.40 Max safety net: $23.88 General Patient Charge: $25.00
Available brands
APO-Bisoprolol
BISOPROLOL-WGR
Bicard 2.5
Bisoprolol Sandoz
Bisoprolol generichealth
Bispro 2.5
Bicor
*Additional charge for this brand is $11.02
 DPMQ: $33.42 Max safety net: $23.88 General Patient Charge: $36.02