BETAMETHASONE DIPROPIONATE

BETAMETHASONE DIPROPIONATE (10801L)

betamethasone (as dipropionate) 0.05% cream, 15 g
10801L
Body System:
Manner of administration:Application
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 6263)

Indication: Corticosteroid-responsive dermatoses
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 8 Max qty units: 8 # of repeats: 5 DPMQ: $45.12 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
DIPROVANT
Eleuphrat
Diprosone
*Additional charge for this brand is $19.60
 DPMQ: $64.72 Max safety net: $25.00 General Patient Charge: $44.60