PANTOPRAZOLE
Manner of administration:Oral
Restriction
Indication: Gastro-oesophageal reflux disease
Restriction
Indication: Scleroderma oesophagus
Restriction
Indication: Zollinger-Ellison syndrome
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
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| Max qty packs: 2 | Max qty units: 60 | # of repeats: 5 | DPMQ: $19.84 | Max safety net: $21.38 | General Patient Charge: $24.17 |
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DPMQ: $29.22 | Max safety net: $21.38 | General Patient Charge: $33.55 | ||
Manner of administration:Oral
Restriction
Indication: Gastro-oesophageal reflux disease
Restriction
Indication: Scleroderma oesophagus
Restriction
Indication: Zollinger-Ellison syndrome
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: $17.10 | Max safety net: $18.64 | General Patient Charge: $21.43 |
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DPMQ: $21.79 | Max safety net: $18.64 | General Patient Charge: $26.12 | ||