PRAVASTATIN

PRAVASTATIN (13432Y)

pravastatin sodium 40 mg tablet, 30
13432Y
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: 60 # of repeats: 5 DPMQ: $21.90 Max safety net: $23.44 General Patient Charge: $25.00
Available brands
APX-Pravastatin
Cholstat 40
Lipostat 40
PRAVASTATIN-WGR
Pravastatin Sandoz
Pravachol
*Additional charge for this brand is $9.50
 DPMQ: $31.40 Max safety net: $23.44 General Patient Charge: $34.50

PRAVASTATIN (8197K)

pravastatin sodium 40 mg tablet, 30
8197K
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: $18.13 Max safety net: $19.67 General Patient Charge: $22.46
Available brands
APX-Pravastatin
Cholstat 40
Lipostat 40
PRAVASTATIN-WGR
Pravastatin Sandoz
Pravachol
*Additional charge for this brand is $4.75
 DPMQ: $22.88 Max safety net: $19.67 General Patient Charge: $27.21