AMOXICILLIN

AMOXICILLIN (11998L)

amoxicillin 250 mg capsule, 20
11998L
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: 40 # of repeats: 0 DPMQ: $19.22 Max safety net: $20.70 General Patient Charge: $23.49
Available brands
AMILOXYN
APO-Amoxycillin
Alphamox 250
Cilamox
Amoxil
*Additional charge for this brand is $9.36
 DPMQ: $28.58 Max safety net: $20.70 General Patient Charge: $32.85

AMOXICILLIN (1884E)

amoxicillin 250 mg capsule, 20
1884E
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: 20 # of repeats: 0 DPMQ: $16.50 Max safety net: $17.98 General Patient Charge: $20.77
Available brands
AMILOXYN
APO-Amoxycillin
Alphamox 250
Cilamox
Amoxil
*Additional charge for this brand is $4.68
 DPMQ: $21.18 Max safety net: $17.98 General Patient Charge: $25.45

AMOXICILLIN (3301R)

amoxicillin 250 mg capsule, 20
3301R
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: 20 # of repeats: 0 DPMQ: $16.50 Max safety net: $17.98 General Patient Charge: $20.77
Available brands
AMILOXYN
APO-Amoxycillin
Alphamox 250
Cilamox
Amoxil
*Additional charge for this brand is $4.68
 DPMQ: $21.18 Max safety net: $17.98 General Patient Charge: $25.45