CLONAZEPAM
clonazepam 1 mg/mL injection [5 x 1 mL ampoules] (&) inert substance diluent [5 x
1 mL ampoules], 1 pack
Body System:
Manner of administration:Injection
Restriction
Indication: For use in patients receiving palliative care
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 5 | # of repeats: 1 | DPMQ: $24.36 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Rivotril | |||||
clonazepam 1 mg/mL injection [5 x 1 mL ampoules] (&) inert substance diluent [5 x
1 mL ampoules], 1 pack
Body System:
Manner of administration:Injection
Restriction
Indication: Epilepsy
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 5 | # of repeats: 0 | DPMQ: $24.36 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Rivotril | |||||