BETAMETHASONE DIPROPIONATE

BETAMETHASONE DIPROPIONATE (10823P)

betamethasone (as dipropionate) 0.05% ointment, 15 g
10823P
Body System:
Manner of administration:Application
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 6231)

Indication: Corticosteroid-responsive dermatoses
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 10 Max qty units: 10 # of repeats: 5 DPMQ: $52.98 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
DIPROVANT
Eleuphrat
Diprosone
*Additional charge for this brand is $24.50
 DPMQ: $77.48 Max safety net: $25.00 General Patient Charge: $49.50