MICONAZOLE
Body System:
Manner of administration:Application
Restriction (Streamlined authority code: 6434)
Indication: Fungal or yeast infection
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: 2 | DPMQ: $19.76 | Max safety net: $21.30 | General Patient Charge: $24.09 |
| Available brands | |||||
| Daktarin | |||||
Body System:
Manner of administration:Application
Restriction (Streamlined authority code: 6434)
Indication: Fungal or yeast infection
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: $20.94 | Max safety net: $22.48 | General Patient Charge: $25.00 |
| Available brands | |||||
| Daktarin | |||||
Body System:
Manner of administration:Application
Restriction (Streamlined authority code: 6434)
Indication: Fungal or yeast infection
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: 2 | DPMQ: $20.25 | Max safety net: $21.79 | General Patient Charge: $24.58 |
| Available brands | |||||
| Daktarin | |||||
Body System:
Manner of administration:Application
Restriction (Streamlined authority code: 6434)
Indication: Fungal or yeast infection
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: 2 | DPMQ: $22.58 | Max safety net: $24.12 | General Patient Charge: $25.00 |
| Available brands | |||||
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