HALOPERIDOL

HALOPERIDOL (12519X)

haloperidol 5 mg/mL injection, 10 x 1 mL ampoules
12519X
Body System:
Manner of administration:Injection
Palliative Care
Restricted Benefit

Restriction

Indication: For use in patients receiving palliative care
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 10 # of repeats: 2 DPMQ: $24.99 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
HALOPERIDOL MEDSURGE
Serenace

HALOPERIDOL (2768Q)

haloperidol 5 mg/mL injection, 10 x 1 mL ampoules
2768Q
Body System:
Manner of administration:Injection
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: 10 # of repeats: 0 DPMQ: $24.99 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
HALOPERIDOL MEDSURGE
Serenace

HALOPERIDOL (3456X)

haloperidol 5 mg/mL injection, 10 x 1 mL ampoules
3456X
Body System:
Manner of administration:Injection
Prescriber Bag
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: 10 # of repeats: 0 DPMQ: $24.99 Max safety net: $0.00 General Patient Charge: Nil
Available brands
HALOPERIDOL MEDSURGE
Serenace