LISINOPRIL

lisinopril 20 mg tablet, 30
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: $22.42 Max safety net: $23.96 General Patient Charge: $25.00
Available brands
APO-Lisinopril
Fibsol 20
LISINOPRIL-WGR
Lisinopril Sandoz
Zinopril 20
Zestril
*Additional charge for this brand is $9.24
DPMQ: $31.66 Max safety net: $23.96 General Patient Charge: $34.24
lisinopril 20 mg tablet, 30
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: $18.39 Max safety net: $19.93 General Patient Charge: $22.72
Available brands
APO-Lisinopril
Fibsol 20
LISINOPRIL-WGR
Lisinopril Sandoz
Zinopril 20
Zestril
*Additional charge for this brand is $4.62
DPMQ: $23.01 Max safety net: $19.93 General Patient Charge: $27.34