VALSARTAN

VALSARTAN (13566B)

valsartan 160 mg tablet, 28
13566B
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: 56 # of repeats: 5 DPMQ: $27.54 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Dilart
Diovan

VALSARTAN (9370E)

valsartan 160 mg tablet, 28
9370E
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: 28 # of repeats: 5 DPMQ: $20.66 Max safety net: $22.14 General Patient Charge: $24.93
Available brands
Dilart
Diovan