HYDROCORTISONE ACETATE

HYDROCORTISONE ACETATE (10831C)

hydrocortisone acetate 1% ointment, 30 g
10831C
Body System:
Manner of administration:Application
Repatriation Pharmaceutical Benefits
Restricted Benefit

Restriction

Indication: Corticosteroid-responsive dermatoses
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: - Max safety net: - General Patient Charge: -
Available brands
Cortic-DS 1% DPMQ: $19.01 Max safety net: $7.70 General Patient Charge: $7.70