OLANZAPINE
Body System:
Manner of administration:Oral
Restriction (Streamlined authority code: 4246)
Indication: Schizophrenia
Restriction (Streamlined authority code: 5869)
Indication: Bipolar I disorder
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
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| Max qty packs: 1 | Max qty units: 28 | # of repeats: 5 | DPMQ: $20.61 | Max safety net: $22.09 | General Patient Charge: $24.88 |
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DPMQ: $25.53 | Max safety net: $22.09 | General Patient Charge: $29.80 | ||