OXAZEPAM

OXAZEPAM (3133X)

oxazepam 30 mg tablet, 25
3133X
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: 25 # of repeats: 0 DPMQ: $16.50 Max safety net: $17.98 General Patient Charge: $20.77
Available brands
APO-Oxazepam
Alepam 30
OXAZEPAM-WGR
Murelax
*Additional charge for this brand is $0.84
 DPMQ: $17.34 Max safety net: $17.98 General Patient Charge: $21.61
Serepax
*Additional charge for this brand is $3.92
 DPMQ: $20.42 Max safety net: $17.98 General Patient Charge: $24.69

OXAZEPAM (3135B)

oxazepam 30 mg tablet, 25
3135B
Body System:
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Malignant neoplasia (late stage)

Restriction

Indication: Anxiety

Restriction

Indication: Anxiety
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 50 # of repeats: 5 DPMQ: $19.22 Max safety net: $20.70 General Patient Charge: $23.49
Available brands
APO-Oxazepam
Alepam 30
OXAZEPAM-WGR
Murelax
*Additional charge for this brand is $1.68
 DPMQ: $20.90 Max safety net: $20.70 General Patient Charge: $25.17
Serepax
*Additional charge for this brand is $7.84
 DPMQ: $27.06 Max safety net: $20.70 General Patient Charge: $31.33

OXAZEPAM (5193H)

oxazepam 30 mg tablet, 25
5193H
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: 25 # of repeats: 0 DPMQ: $16.50 Max safety net: $17.98 General Patient Charge: $20.77
Available brands
APO-Oxazepam
Alepam 30
OXAZEPAM-WGR
Murelax
*Additional charge for this brand is $0.84
 DPMQ: $17.34 Max safety net: $17.98 General Patient Charge: $21.61
Serepax
*Additional charge for this brand is $3.92
 DPMQ: $20.42 Max safety net: $17.98 General Patient Charge: $24.69

OXAZEPAM (5372R)

oxazepam 30 mg tablet, 25
5372R
Body System:
Manner of administration:Oral
Palliative Care
Authority Required

Restriction

Indication: Anxiety
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 50 # of repeats: 3 DPMQ: $19.22 Max safety net: $20.70 General Patient Charge: $23.49
Available brands
APO-Oxazepam
Alepam 30
OXAZEPAM-WGR
Murelax
*Additional charge for this brand is $1.68
 DPMQ: $20.90 Max safety net: $20.70 General Patient Charge: $25.17
Serepax
*Additional charge for this brand is $7.84
 DPMQ: $27.06 Max safety net: $20.70 General Patient Charge: $31.33