CLARITHROMYCIN

CLARITHROMYCIN (8318T)

clarithromycin 250 mg tablet, 14
8318T
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: 14 # of repeats: 1 DPMQ: $17.45 Max safety net: $18.93 General Patient Charge: $21.72
Available brands
Clarithro 250
Clarithromycin Sandoz
Kalixocin
Klacid
*Additional charge for this brand is $3.33
 DPMQ: $20.78 Max safety net: $18.93 General Patient Charge: $25.05

CLARITHROMYCIN (9192T)

clarithromycin 250 mg/5 mL powder for oral liquid, 50 mL
9192T
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Bordetella pertussis

Restriction

Indication: Atypical mycobacterial 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: 1 # of repeats: 0 DPMQ: $33.06 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Klacid