TOPIRAMATE
Body System:
Manner of administration:Oral
Restriction (Streamlined authority code: 17525)
Indication: Seizures
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 120 | # of repeats: 5 | DPMQ: $32.42 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Topamax Sprinkle | |||||
Body System:
Manner of administration:Oral
Restriction (Streamlined authority code: 17488)
Indication: Seizures
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 60 | # of repeats: 5 | DPMQ: $23.10 | Max safety net: $24.58 | General Patient Charge: $25.00 |
| Available brands | |||||
| Topamax Sprinkle | |||||