OXYCODONE
oxycodone hydrochloride 20 mg modified release tablet, 28
OXYCODONE (12510K)
12510K
Body System:
Manner of administration:Oral
Restriction
Indication: Severe disabling pain
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 56 | # of repeats: 0 | DPMQ: $58.26 | Max safety net: $25.00 | General Patient Charge: $25.00 |
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