EPROSARTAN + HYDROCHLOROTHIAZIDE

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: 56 # of repeats: 5 DPMQ: $39.38 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Teveten Plus 600/12.5
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: 28 # of repeats: 5 DPMQ: $26.58 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Teveten Plus 600/12.5