TRIAMCINOLONE

TRIAMCINOLONE (2118L)

triamcinolone acetonide 0.02% ointment, 100 g
2118L
Body System:
Manner of administration:Application
General Schedule
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: 2 Max qty units: 2 # of repeats: 0 DPMQ: $21.32 Max safety net: $22.80 General Patient Charge: $25.00
Available brands
Tricortone
Aristocort 0.02%
*Additional charge for this brand is $3.28
 DPMQ: $24.60 Max safety net: $22.80 General Patient Charge: $28.28