ONDANSETRON

ondansetron 4 mg/5 mL oral liquid, 50 mL

ONDANSETRON (5848T)

ondansetron 4 mg/5 mL oral liquid, 50 mL
5848T
Manner of administration:Oral
Section 100 (CT)
Restricted Benefit

Restriction

Indication: Nausea and vomiting
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 0 DPMQ: $80.78 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
ONDANSETRON-AFT
Zofran syrup 50 mL