MIDAZOLAM

MIDAZOLAM (14270C)

midazolam 10 mg/mL oral liquid, 1 mL syringe
14270C
Body System:
Manner of administration:Buccal
General Schedule
Authority Required

Restriction

Indication: Generalized convulsive status epilepticus
Treatment phase: Initial treatment
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: $279.74 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Zyamis

MIDAZOLAM (14299N)

midazolam 10 mg/mL oral liquid, 1 mL syringe
14299N
Body System:
Manner of administration:Buccal
General Schedule
Authority Required

Restriction

Indication: Generalized convulsive status epilepticus
Treatment phase: Continuing treatment
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: $279.74 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Zyamis