DICLOXACILLIN

dicloxacillin 500 mg capsule, 24

DICLOXACILLIN (10790X)

dicloxacillin 500 mg capsule, 24
10790X
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 6188)

Indication: Osteomyelitis
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: $30.00 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
ARX-Dicloxacillin
DICLOXACILLIN VIATRIS 500
Distaph 500
*Additional charge for this brand is $3.90
 DPMQ: $33.90 Max safety net: $25.00 General Patient Charge: $28.90