OXCARBAZEPINE

OXCARBAZEPINE (13935K)

oxcarbazepine 600 mg tablet, 100
13935K
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17509)

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: 200 # of repeats: 5 DPMQ: $259.06 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Trileptal

OXCARBAZEPINE (13936L)

oxcarbazepine 60 mg/mL oral liquid, 250 mL
13936L
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17509)

Indication: Seizures
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 4 Max qty units: 4 # of repeats: 5 DPMQ: $190.32 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Trileptal

OXCARBAZEPINE (14033N)

oxcarbazepine 300 mg tablet, 100
14033N
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17509)

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: 200 # of repeats: 5 DPMQ: $158.58 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Trileptal

OXCARBAZEPINE (14562K)

oxcarbazepine 150 mg tablet, 100
14562K
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17509)

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: 200 # of repeats: 5 DPMQ: $100.24 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Trileptal

OXCARBAZEPINE (8584T)

oxcarbazepine 150 mg tablet, 100
8584T
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17478)

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: 100 # of repeats: 5 DPMQ: $57.01 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Trileptal

OXCARBAZEPINE (8585W)

oxcarbazepine 300 mg tablet, 100
8585W
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17478)

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: 100 # of repeats: 5 DPMQ: $85.12 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Trileptal

OXCARBAZEPINE (8586X)

oxcarbazepine 600 mg tablet, 100
8586X
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17478)

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: 100 # of repeats: 5 DPMQ: $133.93 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Trileptal

OXCARBAZEPINE (8588B)

oxcarbazepine 60 mg/mL oral liquid, 250 mL
8588B
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17478)

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: 2 # of repeats: 5 DPMQ: $100.24 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Trileptal