METOPROLOL SUCCINATE

METOPROLOL SUCCINATE (13543T)

METOPROLOL SUCCINATE Tablet 47.5 mg (controlled release), 30
13543T
Body System:
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: $50.22 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 (8733P)

METOPROLOL SUCCINATE Tablet 47.5 mg (controlled release), 30
8733P
Body System:
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: $32.00 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Metrol-XL 47.5
Minax XL
Topreloc-XL
Toprol-XL 47.5