PROPRANOLOL

PROPRANOLOL (13386M)

propranolol hydrochloride 10 mg tablet, 100
13386M
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: 5 DPMQ: $20.96 Max safety net: $22.50 General Patient Charge: $25.00
Available brands
APO-Propranolol
PROPRANOLOL-WGR
Deralin 10
*Additional charge for this brand is $5.58
 DPMQ: $26.54 Max safety net: $22.50 General Patient Charge: $30.58
Inderal
*Additional charge for this brand is $16.24
 DPMQ: $37.20 Max safety net: $22.50 General Patient Charge: $41.24

PROPRANOLOL (13542R)

propranolol hydrochloride 40 mg tablet, 100
13542R
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: 5 DPMQ: $21.46 Max safety net: $23.00 General Patient Charge: $25.00
Available brands
APO-Propranolol
PROPRANOLOL-WGR
Deralin 40
*Additional charge for this brand is $5.60
 DPMQ: $27.06 Max safety net: $23.00 General Patient Charge: $30.60
Inderal
*Additional charge for this brand is $16.26
 DPMQ: $37.72 Max safety net: $23.00 General Patient Charge: $41.26

PROPRANOLOL (2565B)

propranolol hydrochloride 10 mg tablet, 100
2565B
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: 5 DPMQ: $17.66 Max safety net: $19.20 General Patient Charge: $21.99
Available brands
APO-Propranolol
PROPRANOLOL-WGR
Deralin 10
*Additional charge for this brand is $2.79
 DPMQ: $20.45 Max safety net: $19.20 General Patient Charge: $24.78
Inderal
*Additional charge for this brand is $8.12
 DPMQ: $25.78 Max safety net: $19.20 General Patient Charge: $30.11

PROPRANOLOL (2566C)

propranolol hydrochloride 40 mg tablet, 100
2566C
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: 5 DPMQ: $17.91 Max safety net: $19.45 General Patient Charge: $22.24
Available brands
APO-Propranolol
PROPRANOLOL-WGR
Deralin 40
*Additional charge for this brand is $2.80
 DPMQ: $20.71 Max safety net: $19.45 General Patient Charge: $25.04
Inderal
*Additional charge for this brand is $8.13
 DPMQ: $26.04 Max safety net: $19.45 General Patient Charge: $30.37