EZETIMIBE

EZETIMIBE (13440J)

ezetimibe 10 mg tablet, 30
13440J
Body System:
Manner of administration:Oral
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: 60 # of repeats: 5 DPMQ: $23.16 Max safety net: $24.64 General Patient Charge: $25.00
Available brands
APO-Ezetimibe
ARX-EZETIMIBE
BTC Ezetimibe
EZEMICHOL
EZETIMIBE-WGR
Ezetimibe GH
Ezetimibe Sandoz
Pharmacor Ezetimibe 10
Zient 10mg
Ezetrol
*Additional charge for this brand is $6.78
 DPMQ: $29.94 Max safety net: $24.64 General Patient Charge: $31.78

EZETIMIBE (8757X)

ezetimibe 10 mg tablet, 30
8757X
Body System:
Manner of administration:Oral
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: 30 # of repeats: 5 DPMQ: $18.47 Max safety net: $19.95 General Patient Charge: $22.74
Available brands
APO-Ezetimibe
ARX-EZETIMIBE
BTC Ezetimibe
EZEMICHOL
EZETIMIBE-WGR
Ezetimibe GH
Ezetimibe Sandoz
Pharmacor Ezetimibe 10
Zient 10mg
Ezetrol
*Additional charge for this brand is $3.39
 DPMQ: $21.86 Max safety net: $19.95 General Patient Charge: $26.13