CLOPIDOGREL
Body System:
Manner of administration:Oral
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: $22.44 | Max safety net: $23.98 | General Patient Charge: $25.00 |
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Body System:
Manner of administration:Oral
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: $22.44 | Max safety net: $23.98 | General Patient Charge: $25.00 |
| Available brands | |||||
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Body System:
Manner of administration:Oral
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: 1.86666667 | Max qty units: 56 | # of repeats: 5 | DPMQ: $37.99 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
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Body System:
Manner of administration:Oral
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 0.9333333300000001 | Max qty units: 28 | # of repeats: 5 | DPMQ: $36.91 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
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Body System:
Manner of administration:Oral
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: 1.86666667 | Max qty units: 56 | # of repeats: 5 | DPMQ: $58.05 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
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Body System:
Manner of administration:Oral
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 0.9333333300000001 | Max qty units: 28 | # of repeats: 5 | DPMQ: $26.78 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
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Body System:
Manner of administration:Oral
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: $18.40 | Max safety net: $19.94 | General Patient Charge: $22.73 |
| Available brands | |||||
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Body System:
Manner of administration:Oral
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: $18.40 | Max safety net: $19.94 | General Patient Charge: $22.73 |
| Available brands | |||||
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