METOPROLOL SUCCINATE

METOPROLOL SUCCINATE Tablet 190 mg (controlled release), 30
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Moderate to severe heart failure
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 60 # of repeats: 5 DPMQ: $69.58 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Metrol-XL 190
Minax XL
Topreloc-XL
Toprol-XL 190
METOPROLOL SUCCINATE Tablet 47.5 mg (controlled release), 30
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Moderate to severe heart failure
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 60 # of repeats: 5 DPMQ: $49.70 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Metrol-XL 47.5
Minax XL
Topreloc-XL
Toprol-XL 47.5
METOPROLOL SUCCINATE Tablet 95 mg (controlled release), 30
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Moderate to severe heart failure
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 60 # of repeats: 5 DPMQ: $58.52 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Metrol-XL 95
Minax XL
Topreloc-XL
Toprol-XL 95
METOPROLOL SUCCINATE Tablet 23.75 mg (controlled release), 15
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Moderate to severe heart failure
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 15 # of repeats: 0 DPMQ: $18.60 Max safety net: $20.14 General Patient Charge: $22.93
Available brands
Metrol-XL 23.75
Minax XL
Topreloc-XL
METOPROLOL SUCCINATE Tablet 47.5 mg (controlled release), 30
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Moderate to severe heart failure
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: $32.03 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Metrol-XL 47.5
Minax XL
Topreloc-XL
Toprol-XL 47.5
METOPROLOL SUCCINATE Tablet 95 mg (controlled release), 30
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Moderate to severe heart failure
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: $36.44 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Metrol-XL 95
Minax XL
Topreloc-XL
Toprol-XL 95
METOPROLOL SUCCINATE Tablet 190 mg (controlled release), 30
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Moderate to severe heart failure
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: $41.97 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Metrol-XL 190
Minax XL
Topreloc-XL
Toprol-XL 190