METRONIDAZOLE

metronidazole 400 mg tablet, 21

METRONIDAZOLE (1621H)

metronidazole 400 mg tablet, 21
1621H
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Anaerobic 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: 21 # of repeats: 1 DPMQ: $17.47 Max safety net: $18.95 General Patient Charge: $21.74
Available brands
METRONIDAMED
Metrogyl 400
Flagyl
*Additional charge for this brand is $2.50
 DPMQ: $19.97 Max safety net: $18.95 General Patient Charge: $24.24