ROXITHROMYCIN

ROXITHROMYCIN (11993F)

roxithromycin 300 mg tablet, 5
11993F
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: 10 # of repeats: 0 DPMQ: $20.46 Max safety net: $22.00 General Patient Charge: $24.79
Available brands
APX-Roxithromycin
ROXITHROMYCIN-WGR
Roxar 300
Roxithromycin Sandoz

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: $20.46 Max safety net: $22.00 General Patient Charge: $24.79
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: $17.41 Max safety net: $18.95 General Patient Charge: $21.74
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: $17.41 Max safety net: $18.95 General Patient Charge: $21.74
Available brands
APX-Roxithromycin
ROXITHROMYCIN-WGR
Roxar 150
Roxithromycin Sandoz

ROXITHROMYCIN (5261X)

roxithromycin 300 mg tablet, 5
5261X
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: 5 # of repeats: 0 DPMQ: $17.41 Max safety net: $18.95 General Patient Charge: $21.74
Available brands
APX-Roxithromycin
ROXITHROMYCIN-WGR
Roxar 300
Roxithromycin Sandoz

ROXITHROMYCIN (8016X)

roxithromycin 300 mg tablet, 5
8016X
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: 5 # of repeats: 0 DPMQ: $17.41 Max safety net: $18.95 General Patient Charge: $21.74
Available brands
APX-Roxithromycin
ROXITHROMYCIN-WGR
Roxar 300
Roxithromycin Sandoz