METHYLPREDNISOLONE

methylprednisolone aceponate 0.1% ointment, 15 g

METHYLPREDNISOLONE (10845T)

methylprednisolone aceponate 0.1% ointment, 15 g
10845T
Body System:
Manner of administration:Application
General Schedule
Authority Required (STREAMLINED)

Restriction  6231

Indication: Corticosteroid-responsive dermatoses
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 10 Max qty units: 10 # of repeats: 5 DPMQ: $66.98 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Metvant
Supriad Ointment
Advantan
*Additional charge for this brand is $39.40
 DPMQ: $106.38 Max safety net: $25.00 General Patient Charge: $64.40