ROXITHROMYCIN

ROXITHROMYCIN (12001P)

roxithromycin 150 mg tablet, 10
12001P
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 10404)

Indication: Infection
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 20 # of repeats: 0 DPMQ: $19.84 Max safety net: $21.32 General Patient Charge: $24.11
Available brands
APX-Roxithromycin
ROXITHROMYCIN-WGR
Roxar 150
Roxithromycin Sandoz

ROXITHROMYCIN (1760P)

roxithromycin 150 mg tablet, 10
1760P
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: 10 # of repeats: 0 DPMQ: $16.81 Max safety net: $18.29 General Patient Charge: $21.08
Available brands
APX-Roxithromycin
ROXITHROMYCIN-WGR
Roxar 150
Roxithromycin Sandoz

ROXITHROMYCIN (5260W)

roxithromycin 150 mg tablet, 10
5260W
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: 10 # of repeats: 0 DPMQ: $16.81 Max safety net: $18.29 General Patient Charge: $21.08
Available brands
APX-Roxithromycin
ROXITHROMYCIN-WGR
Roxar 150
Roxithromycin Sandoz