DIAZEPAM

diazepam 2 mg tablet, 50

DIAZEPAM (5355W)

diazepam 2 mg tablet, 50
5355W
Body System:
Manner of administration:Oral
Palliative Care
Authority Required

Restriction

Indication: Anxiety
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: 3 DPMQ: $17.10 Max safety net: $18.64 General Patient Charge: $21.43
Available brands
APX-Diazepam
DIAZEPAM-WGR
Valpam 2
Antenex 2
*Additional charge for this brand is $2.78
 DPMQ: $19.88 Max safety net: $18.64 General Patient Charge: $24.21