FUROSEMIDE

FUROSEMIDE (13504R)

furosemide 10 mg/mL oral liquid, 30 mL
13504R
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: 2 # of repeats: 3 DPMQ: $69.28 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Lasix

FUROSEMIDE (2411X)

furosemide 10 mg/mL oral liquid, 30 mL
2411X
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: 1 # of repeats: 3 DPMQ: $41.53 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Lasix