AMOXICILLIN

AMOXICILLIN (1887H)

amoxicillin 250 mg/5 mL powder for oral liquid, 100 mL
1887H
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: 1 # of repeats: 1 DPMQ: $19.86 Max safety net: $21.77 General Patient Charge: $24.56
Available brands
AMOXICILLIN-WGR
APO-Amoxycillin
Amoxycillin Sandoz
Amoxil Forte
*Additional charge for this brand is $4.32
 DPMQ: $24.18 Max safety net: $21.77 General Patient Charge: $28.88

AMOXICILLIN (3393N)

amoxicillin 250 mg/5 mL powder for oral liquid, 100 mL
3393N
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: 1 # of repeats: 0 DPMQ: $19.86 Max safety net: $21.77 General Patient Charge: $24.56
Available brands
AMOXICILLIN-WGR
APO-Amoxycillin
Amoxycillin Sandoz
Amoxil Forte
*Additional charge for this brand is $4.32
 DPMQ: $24.18 Max safety net: $21.77 General Patient Charge: $28.88