MODAFINIL
modafinil 100 mg tablet, 60
MODAFINIL (8816B)
8816B
Manner of administration:Oral
Restriction
Indication: Narcolepsy
Treatment phase: Initial 1 - treatment of narcolepsy without cataplexy
Restriction
Indication: Narcolepsy
Treatment phase: Initial 2 - treatment of narcolepsy with cataplexy
Restriction
Indication: Narcolepsy
Treatment phase: Continuing or change of treatment
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
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| Max qty packs: 2 | Max qty units: 120 | # of repeats: 5 | DPMQ: $115.30 | Max safety net: $25.00 | General Patient Charge: $25.00 |
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DPMQ: $124.42 | Max safety net: $25.00 | General Patient Charge: $34.12 | ||