FUROSEMIDE

FUROSEMIDE (13473D)

furosemide 20 mg tablet, 100
13473D
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: $24.84 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
APO-Frusemide
FUROSEMIDE-WGR
UREMIDE 20
Frusemix-M
*Additional charge for this brand is $2.02
 DPMQ: $26.86 Max safety net: $25.00 General Patient Charge: $27.02

FUROSEMIDE (2414C)

furosemide 20 mg tablet, 100
2414C
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: $19.60 Max safety net: $21.14 General Patient Charge: $23.93
Available brands
APO-Frusemide
FUROSEMIDE-WGR
UREMIDE 20
Frusemix-M
*Additional charge for this brand is $1.01
 DPMQ: $20.61 Max safety net: $21.14 General Patient Charge: $24.94