NICORANDIL
Body System:
Manner of administration:Oral
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: 2 | # of repeats: 5 | DPMQ: $31.20 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
|
|
|||||
|
|
|||||
Body System:
Manner of administration:Oral
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: 2 | # of repeats: 5 | DPMQ: $37.80 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
|
|
|||||
|
|
|||||
Body System:
Manner of administration:Oral
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 1 | # of repeats: 5 | DPMQ: $22.78 | Max safety net: $24.32 | General Patient Charge: $25.00 |
| Available brands | |||||
|
|
|||||
|
|
|||||
Body System:
Manner of administration:Oral
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 1 | # of repeats: 5 | DPMQ: $26.08 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
|
|
|||||
|
|
|||||