CALCIPOTRIOL + BETAMETHASONE DIPROPIONATE
calcipotriol 0.005% + betamethasone (as dipropionate) 0.05% ointment, 30 g
Body System:
Manner of administration:Application
Restriction
Indication: Chronic stable plaque type psoriasis vulgaris
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 2 | # of repeats: 1 | DPMQ: $65.04 | Max safety net: $25.00 | General Patient Charge: $25.00 |
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calcipotriol 0.005% + betamethasone (as dipropionate) 0.05% ointment, 30 g
Body System:
Manner of administration:Application
Restriction
Indication: Chronic stable plaque type psoriasis vulgaris
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: $39.41 | Max safety net: $25.00 | General Patient Charge: $25.00 |
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