DIAZEPAM

diazepam 5 mg tablet, 50

DIAZEPAM (5072Y)

diazepam 5 mg tablet, 50
5072Y
Body System:
Manner of administration:Oral
General Schedule
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 50 # of repeats: 0 DPMQ: $16.70 Max safety net: $18.18 General Patient Charge: $20.97
Available brands
APX-Diazepam
Antenex 5
DIAZEPAM-WGR
Valpam 5
Valium
*Additional charge for this brand is $3.08
 DPMQ: $19.78 Max safety net: $18.18 General Patient Charge: $24.05