IRBESARTAN

Body System:

Manner of administration:Oral

General Schedule

Restricted Benefit

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: $19.84	Max safety net: $21.38	General Patient Charge: $24.17
Available brands
APO-Irbesartan
AVSARTAN
Abisart 150
Blooms Irbesartan
IRBESARTAN-WGR
Irbesartan Sandoz
Avapro *Additional charge for this brand is $7.62			DPMQ: $27.46	Max safety net: $21.38	General Patient Charge: $31.79
Karvea *Additional charge for this brand is $7.62			DPMQ: $27.46	Max safety net: $21.38	General Patient Charge: $31.79

Body System:

Manner of administration:Oral

General Schedule

Restricted Benefit

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

Body System:

Manner of administration:Oral

General Schedule

No restrictions

Quantities & Cost

Max qty packs	Max qty units	# of repeats	DPMQ	Max safety net	General Patient Charge
Max qty packs: 1	Max qty units: 30	# of repeats: 5	DPMQ: $17.10	Max safety net: $18.64	General Patient Charge: $21.43
Available brands
APO-Irbesartan
AVSARTAN
Abisart 150
Blooms Irbesartan
IRBESARTAN-WGR
Irbesartan Sandoz
Avapro *Additional charge for this brand is $3.81			DPMQ: $20.91	Max safety net: $18.64	General Patient Charge: $25.24
Karvea *Additional charge for this brand is $3.81			DPMQ: $20.91	Max safety net: $18.64	General Patient Charge: $25.24

Body System:

Manner of administration:Oral

General Schedule

No restrictions

Quantities & Cost

Max qty packs	Max qty units	# of repeats	DPMQ	Max safety net	General Patient Charge
Max qty packs: 1	Max qty units: 30	# of repeats: 5	DPMQ: $18.10	Max safety net: $19.64	General Patient Charge: $22.43
Available brands
APO-Irbesartan
AVSARTAN
Abisart 300
Blooms Irbesartan
IRBESARTAN-WGR
Irbesartan Sandoz
Avapro *Additional charge for this brand is $3.82			DPMQ: $21.92	Max safety net: $19.64	General Patient Charge: $26.25
Karvea *Additional charge for this brand is $3.82			DPMQ: $21.92	Max safety net: $19.64	General Patient Charge: $26.25

IRBESARTAN (13380F)