VANCOMYCIN

vancomycin 500 mg injection, 1 vial

VANCOMYCIN (3131T)

vancomycin 500 mg injection, 1 vial
3131T
Manner of administration:Injection
General Schedule
Restricted Benefit

Restriction

Indication: Endophthalmitis
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 5 Max qty units: 5 # of repeats: 0 DPMQ: $35.33 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
VANCOMYCIN MEDSURGE
Vancomycin Juno
Vancomycin Viatris