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: $17.10 Max safety net: $18.64 General Patient Charge: $21.43
Available brands
APO-Oxazepam
Alepam 30
OXAZEPAM-WGR
Murelax
*Additional charge for this brand is $0.80
 DPMQ: $17.90 Max safety net: $18.64 General Patient Charge: $22.23
Serepax
*Additional charge for this brand is $3.70
 DPMQ: $20.80 Max safety net: $18.64 General Patient Charge: $25.13

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: $19.84 Max safety net: $21.38 General Patient Charge: $24.17
Available brands
APO-Oxazepam
Alepam 30
OXAZEPAM-WGR
Murelax
*Additional charge for this brand is $1.60
 DPMQ: $21.44 Max safety net: $21.38 General Patient Charge: $25.77
Serepax
*Additional charge for this brand is $7.40
 DPMQ: $27.24 Max safety net: $21.38 General Patient Charge: $31.57

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: $17.10 Max safety net: $18.64 General Patient Charge: $21.43
Available brands
APO-Oxazepam
Alepam 30
OXAZEPAM-WGR
Murelax
*Additional charge for this brand is $0.80
 DPMQ: $17.90 Max safety net: $18.64 General Patient Charge: $22.23
Serepax
*Additional charge for this brand is $3.70
 DPMQ: $20.80 Max safety net: $18.64 General Patient Charge: $25.13

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: $19.84 Max safety net: $21.38 General Patient Charge: $24.17
Available brands
APO-Oxazepam
Alepam 30
OXAZEPAM-WGR
Murelax
*Additional charge for this brand is $1.60
 DPMQ: $21.44 Max safety net: $21.38 General Patient Charge: $25.77
Serepax
*Additional charge for this brand is $7.40
 DPMQ: $27.24 Max safety net: $21.38 General Patient Charge: $31.57