AZITHROMYCIN

AZITHROMYCIN (5616N)

azithromycin 600 mg tablet, 8
5616N
Body System:
Manner of administration:Oral
Public
S100 HSD Public
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 6356)

Indication: Mycobacterium avium complex 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: 16 # of repeats: 5 DPMQ: $110.76 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Zithromax

AZITHROMYCIN (6221K)

azithromycin 600 mg tablet, 8
6221K
Body System:
Manner of administration:Oral
Private
S100 HSD Private
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 9604)

Indication: Mycobacterium avium complex 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: 16 # of repeats: 5 DPMQ: $124.08 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Zithromax