NAPROXEN

Body System:

Manner of administration:Oral

General Schedule

Restricted Benefit

Indication: Chronic arthropathies (including osteoarthritis)

Indication: Bone pain

Quantities & Cost

Max qty packs	Max qty units	# of repeats	DPMQ	Max safety net	General Patient Charge
Max qty packs: 1	Max qty units: 50	# of repeats: 3	DPMQ: $19.35	Max safety net: $20.83	General Patient Charge: $23.62
Available brands
Crysanal
Anaprox 550 *Additional charge for this brand is $2.85			DPMQ: $22.20	Max safety net: $20.83	General Patient Charge: $26.47

Body System:

Manner of administration:Oral

General Schedule

Restricted Benefit

Indication: Chronic arthropathies (including osteoarthritis)

Indication: Bone pain

Quantities & Cost

Max qty packs	Max qty units	# of repeats	DPMQ	Max safety net	General Patient Charge
Max qty packs: 1	Max qty units: 50	# of repeats: 0	DPMQ: $19.35	Max safety net: $20.83	General Patient Charge: $23.62
Available brands
Crysanal
Anaprox 550 *Additional charge for this brand is $2.85			DPMQ: $22.20	Max safety net: $20.83	General Patient Charge: $26.47

Body System:

Manner of administration:Oral

Palliative Care

Restricted Benefit

Indication: Severe pain

Quantities & Cost

Max qty packs	Max qty units	# of repeats	DPMQ	Max safety net	General Patient Charge
Max qty packs: 1	Max qty units: 50	# of repeats: 3	DPMQ: $19.35	Max safety net: $20.83	General Patient Charge: $23.62
Available brands
Crysanal
Anaprox 550 *Additional charge for this brand is $2.85			DPMQ: $22.20	Max safety net: $20.83	General Patient Charge: $26.47

NAPROXEN (1795L)