VERAPAMIL

VERAPAMIL (13434C)

verapamil hydrochloride 180 mg modified release tablet, 30
13434C
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: $24.48 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Cordilox 180 SR
Isoptin 180 SR
*Additional charge for this brand is $7.08
 DPMQ: $31.56 Max safety net: $25.00 General Patient Charge: $32.08

VERAPAMIL (2208F)

verapamil hydrochloride 180 mg modified release tablet, 30
2208F
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: $19.13 Max safety net: $20.61 General Patient Charge: $23.40
Available brands
Cordilox 180 SR
Isoptin 180 SR
*Additional charge for this brand is $3.54
 DPMQ: $22.67 Max safety net: $20.61 General Patient Charge: $26.94