DOXYCYCLINE

doxycycline 100 mg modified release capsule, 7

DOXYCYCLINE (2703G)

doxycycline 100 mg modified release capsule, 7
2703G
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Pelvic inflammatory disease
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: 0 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Doryx
*Additional charge for this brand is $11.80
 DPMQ: $36.36 Max safety net: $25.00 General Patient Charge: $36.80
Mayne Pharma Doxycycline
*Additional charge for this brand is $6.16
 DPMQ: $30.72 Max safety net: $25.00 General Patient Charge: $31.16