AZITHROMYCIN

azithromycin 500 mg tablet, 3

AZITHROMYCIN (4115N)

azithromycin 500 mg tablet, 3
4115N
Body System:
Manner of administration:Oral
Repatriation Pharmaceutical Benefits
Restricted Benefit

Restriction

Indication: Upper and lower respiratory tract infections
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 3 # of repeats: 0 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Zithromax DPMQ: $35.61 Max safety net: $7.70 General Patient Charge: $7.70
APO-Azithromycin DPMQ: $35.61 Max safety net: $7.70 General Patient Charge: $7.70
Azithromycin Mylan DPMQ: $35.61 Max safety net: $7.70 General Patient Charge: $7.70
Azithromycin Sandoz DPMQ: $35.61 Max safety net: $7.70 General Patient Charge: $7.70
Azithromycin Viatris DPMQ: $35.61 Max safety net: $7.70 General Patient Charge: $7.70
Azithromycin-WGR DPMQ: $35.61 Max safety net: $7.70 General Patient Charge: $7.70
Zedd 500 DPMQ: $35.61 Max safety net: $7.70 General Patient Charge: $7.70
ZITHRO DPMQ: $35.61 Max safety net: $7.70 General Patient Charge: $7.70