OLMESARTAN + HYDROCHLOROTHIAZIDE
olmesartan medoxomil 40 mg + hydrochlorothiazide 25 mg tablet, 30
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 |
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| Max qty packs: 2 | Max qty units: 60 | # of repeats: 5 | DPMQ: $25.26 | Max safety net: $25.00 | General Patient Charge: $25.00 |
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DPMQ: $33.00 | Max safety net: $25.00 | General Patient Charge: $32.74 | ||
olmesartan medoxomil 40 mg + hydrochlorothiazide 25 mg tablet, 30
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: 30 | # of repeats: 5 | DPMQ: $19.52 | Max safety net: $21.00 | General Patient Charge: $23.79 |
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DPMQ: $23.39 | Max safety net: $21.00 | General Patient Charge: $27.66 | ||