LISINOPRIL

Body System:

Manner of administration:Oral

General Schedule

Restricted Benefit

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: $21.96	Max safety net: $23.44	General Patient Charge: $25.00
Available brands
APO-Lisinopril
Fibsol 20
LISINOPRIL-WGR
Lisinopril Sandoz
Zinopril 20
Zestril *Additional charge for this brand is $9.66			DPMQ: $31.62	Max safety net: $23.44	General Patient Charge: $34.66

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: $17.87	Max safety net: $19.35	General Patient Charge: $22.14
Available brands
APO-Lisinopril
Fibsol 20
LISINOPRIL-WGR
Lisinopril Sandoz
Zinopril 20
Zestril *Additional charge for this brand is $4.83			DPMQ: $22.70	Max safety net: $19.35	General Patient Charge: $26.97

LISINOPRIL (13402J)