PIOGLITAZONE

General Schedule
Restricted Benefit

Restriction

Indication: Diabetes mellitus type 2
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: $40.40 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
ARX-PIOGLITAZONE
Vexazone
General Schedule
Restricted Benefit

Restriction

Indication: Diabetes mellitus type 2
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: $27.09 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
ARX-PIOGLITAZONE
Vexazone