BENZYDAMINE

benzydamine hydrochloride 0.15% mouthwash, 500 mL

BENZYDAMINE (5032W)

benzydamine hydrochloride 0.15% mouthwash, 500 mL
5032W
Body System:
Manner of administration:Oral Application
General Schedule
Restricted Benefit

Restriction

Indication: Mucositis
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 0 DPMQ: $22.50 Max safety net: $23.98 General Patient Charge: $25.00
Available brands
Difflam