TESTOSTERONE

TESTOSTERONE (10378F)

testosterone 5% (50 mg/mL) cream, 50 mL
10378F
Body System:
Manner of administration:Transdermal
General Schedule
Authority Required

Restriction

Indication: Androgen deficiency

Restriction

Indication: Androgen deficiency

Restriction

Indication: Micropenis

Restriction

Indication: Pubertal induction

Restriction

Indication: Constitutional delay of growth or puberty
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: 1 DPMQ: $107.87 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
AndroForte 5

TESTOSTERONE (14563L)

testosterone 5% (50 mg/mL) cream, 50 mL
14563L
Body System:
Manner of administration:Transdermal
General Schedule
Authority Required

Restriction

Indication: Androgen deficiency

Restriction

Indication: Androgen deficiency

Restriction

Indication: Micropenis

Restriction

Indication: Pubertal induction

Restriction

Indication: Constitutional delay of growth or puberty
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 2 # of repeats: 1 DPMQ: $206.36 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
AndroForte 5