TOPIRAMATE
topiramate 100 mg tablet, 60
TOPIRAMATE (8165R)
8165R
Body System:
Manner of administration:Oral
Restriction (Streamlined authority code: 17487)
Indication: Seizures
Restriction (Streamlined authority code: 5325)
Indication: Migraine
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 60 | # of repeats: 5 | DPMQ: $22.68 | Max safety net: $24.16 | General Patient Charge: $25.00 |
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