IRBESARTAN

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: 60 # of repeats: 5 DPMQ: $21.84 Max safety net: $23.38 General Patient Charge: $25.00
Available brands
APO-Irbesartan
AVSARTAN
Abisart 300
Blooms Irbesartan
IRBESARTAN-WGR
Irbesartan Sandoz
Avapro
*Additional charge for this brand is $7.64
DPMQ: $29.48 Max safety net: $23.38 General Patient Charge: $32.64
Karvea
*Additional charge for this brand is $7.64
DPMQ: $29.48 Max safety net: $23.38 General Patient Charge: $32.64