CLINDAMYCIN

General Schedule
Restricted Benefit

Restriction

Indication: Gram-positive coccal infections
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 48 # of repeats: 1 DPMQ: $22.40 Max safety net: $23.88 General Patient Charge: $25.00
Available brands
APO-Clindamycin
CLINDAMYCIN-WGR
Calindamin
Clindamycin LU
Clindamyk
Dalacin C
General Schedule
Restricted Benefit

Restriction

Indication: Gram-positive coccal infections
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 24 # of repeats: 0 DPMQ: $18.09 Max safety net: $19.57 General Patient Charge: $22.36
Available brands
APO-Clindamycin
CLINDAMYCIN-WGR
Calindamin
Clindamycin LU
Clindamyk
Dalacin C