TRAMADOL

tramadol hydrochloride 50 mg capsule, 20

TRAMADOL (12008B)

tramadol hydrochloride 50 mg capsule, 20
12008B
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Severe pain
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 0.5 Max qty units: 10 # of repeats: 0 DPMQ: $17.61 Max safety net: $19.15 General Patient Charge: $21.94
Available brands
APO-Tramadol
TRAMADOL-WGR
Tramadol Sandoz
Tramedo
Zydol
Tramal
*Additional charge for this brand is $1.39
 DPMQ: $19.00 Max safety net: $19.15 General Patient Charge: $23.33