PANTOPRAZOLE
pantoprazole 40 mg enteric tablet, 30
PANTOPRAZOLE (14330F)
14330F
Manner of administration:Oral
Restriction (Streamlined authority code: 15658)
Indication: Scleroderma oesophagus
Restriction (Streamlined authority code: 15678)
Indication: Zollinger-Ellison syndrome
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: $20.58 | Max safety net: $22.12 | General Patient Charge: $24.91 |
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DPMQ: $29.96 | Max safety net: $22.12 | General Patient Charge: $34.29 | ||