OLANZAPINE
Body System:
Manner of administration:Oral
Restriction (Streamlined authority code: 4246)
Indication: Schizophrenia
Restriction (Streamlined authority code: 5869)
Indication: Bipolar I disorder
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
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| Max qty packs: 1 | Max qty units: 28 | # of repeats: 5 | DPMQ: $20.21 | Max safety net: $21.75 | General Patient Charge: $24.54 |
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DPMQ: $24.44 | Max safety net: $21.75 | General Patient Charge: $28.77 | ||