DOXYCYCLINE

doxycycline 100 mg modified release capsule, 7

DOXYCYCLINE (10777F)

doxycycline 100 mg modified release capsule, 7
10777F
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Severe acne
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 4 Max qty units: 28 # of repeats: 5 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Doryx
*Additional charge for this brand is $11.00
 DPMQ: $36.32 Max safety net: $25.00 General Patient Charge: $36.00
Mayne Pharma Doxycycline
*Additional charge for this brand is $5.72
 DPMQ: $31.04 Max safety net: $25.00 General Patient Charge: $30.72