FUROSEMIDE

FUROSEMIDE (13472C)

furosemide 40 mg tablet, 100
13472C
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: 200 # of repeats: 1 DPMQ: $19.22 Max safety net: $20.70 General Patient Charge: $23.49
Available brands
APO-Frusemide
FUROSEMIDE-WGR
Frusax
Uremide
Frusemix
*Additional charge for this brand is $2.08
 DPMQ: $21.30 Max safety net: $20.70 General Patient Charge: $25.57

FUROSEMIDE (2412Y)

furosemide 40 mg tablet, 100
2412Y
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: 100 # of repeats: 1 DPMQ: $16.50 Max safety net: $17.98 General Patient Charge: $20.77
Available brands
APO-Frusemide
FUROSEMIDE-WGR
Frusax
Uremide
Frusemix
*Additional charge for this brand is $1.04
 DPMQ: $17.54 Max safety net: $17.98 General Patient Charge: $21.81