CEFALEXIN

CEFALEXIN (11963P)

cefalexin 250 mg capsule, 20
11963P
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 10412)

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
APO-Cephalexin
Cefalexin Viatris
Ibilex 250
Keflex
*Additional charge for this brand is $9.44
 DPMQ: $28.66 Max safety net: $20.70 General Patient Charge: $32.93

CEFALEXIN (2655R)

cefalexin 250 mg capsule, 20
2655R
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 4243)

Indication: Prophylaxis of urinary tract 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: 2 DPMQ: $19.22 Max safety net: $20.70 General Patient Charge: $23.49
Available brands
APO-Cephalexin
Cefalexin Viatris
Ibilex 250
Keflex
*Additional charge for this brand is $9.44
 DPMQ: $28.66 Max safety net: $20.70 General Patient Charge: $32.93

CEFALEXIN (3058Y)

cefalexin 250 mg capsule, 20
3058Y
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
APO-Cephalexin
Cefalexin Viatris
Ibilex 250
Keflex
*Additional charge for this brand is $4.72
 DPMQ: $21.22 Max safety net: $17.98 General Patient Charge: $25.49

CEFALEXIN (3317N)

cefalexin 250 mg capsule, 20
3317N
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
APO-Cephalexin
Cefalexin Viatris
Ibilex 250
Keflex
*Additional charge for this brand is $4.72
 DPMQ: $21.22 Max safety net: $17.98 General Patient Charge: $25.49