AMOXICILLIN

AMOXICILLIN (11947T)

amoxicillin 500 mg capsule, 20
11947T
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 10402)

Indication: Infection
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 40 # of repeats: 0 DPMQ: $19.22 Max safety net: $20.70 General Patient Charge: $23.49
Available brands
AMILOXYN
AMOXICILLIN-WGR
APO-Amoxycillin
Alphamox 500
Amoxycillin Sandoz
Amoxycillin generichealth 500
Blooms The Chemist Amoxicillin
Cilamox
Amoxil
*Additional charge for this brand is $9.34
 DPMQ: $28.56 Max safety net: $20.70 General Patient Charge: $32.83

AMOXICILLIN (11998L)

amoxicillin 250 mg capsule, 20
11998L
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 10404)

Indication: Infection
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 40 # of repeats: 0 DPMQ: $19.22 Max safety net: $20.70 General Patient Charge: $23.49
Available brands
AMILOXYN
APO-Amoxycillin
Alphamox 250
Cilamox
Amoxil
*Additional charge for this brand is $9.36
 DPMQ: $28.58 Max safety net: $20.70 General Patient Charge: $32.85

AMOXICILLIN (1884E)

amoxicillin 250 mg capsule, 20
1884E
Body System:
Manner of administration:Oral
General Schedule
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 20 # of repeats: 0 DPMQ: $16.50 Max safety net: $17.98 General Patient Charge: $20.77
Available brands
AMILOXYN
APO-Amoxycillin
Alphamox 250
Cilamox
Amoxil
*Additional charge for this brand is $4.68
 DPMQ: $21.18 Max safety net: $17.98 General Patient Charge: $25.45

AMOXICILLIN (1886G)

amoxicillin 125 mg/5 mL powder for oral liquid, 100 mL
1886G
Body System:
Manner of administration:Oral
General Schedule
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 1 DPMQ: $19.86 Max safety net: $21.77 General Patient Charge: $24.56
Available brands
APO-Amoxycillin
Amoxycillin Sandoz
Amoxil
*Additional charge for this brand is $4.55
 DPMQ: $24.41 Max safety net: $21.77 General Patient Charge: $29.11

AMOXICILLIN (1887H)

amoxicillin 250 mg/5 mL powder for oral liquid, 100 mL
1887H
Body System:
Manner of administration:Oral
General Schedule
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 1 DPMQ: $19.86 Max safety net: $21.77 General Patient Charge: $24.56
Available brands
AMOXICILLIN-WGR
APO-Amoxycillin
Amoxycillin Sandoz
Amoxil Forte
*Additional charge for this brand is $4.32
 DPMQ: $24.18 Max safety net: $21.77 General Patient Charge: $28.88

AMOXICILLIN (1889K)

amoxicillin 500 mg capsule, 20
1889K
Body System:
Manner of administration:Oral
General Schedule
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 20 # of repeats: 0 DPMQ: $16.50 Max safety net: $17.98 General Patient Charge: $20.77
Available brands
AMILOXYN
AMOXICILLIN-WGR
APO-Amoxycillin
Alphamox 500
Amoxycillin Sandoz
Amoxycillin generichealth 500
Blooms The Chemist Amoxicillin
Cilamox
Amoxil
*Additional charge for this brand is $4.67
 DPMQ: $21.17 Max safety net: $17.98 General Patient Charge: $25.44

AMOXICILLIN (3300Q)

amoxicillin 500 mg capsule, 20
3300Q
Body System:
Manner of administration:Oral
General Schedule
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 20 # of repeats: 0 DPMQ: $16.50 Max safety net: $17.98 General Patient Charge: $20.77
Available brands
AMILOXYN
AMOXICILLIN-WGR
APO-Amoxycillin
Alphamox 500
Amoxycillin Sandoz
Amoxycillin generichealth 500
Blooms The Chemist Amoxicillin
Cilamox
Amoxil
*Additional charge for this brand is $4.67
 DPMQ: $21.17 Max safety net: $17.98 General Patient Charge: $25.44

AMOXICILLIN (3301R)

amoxicillin 250 mg capsule, 20
3301R
Body System:
Manner of administration:Oral
General Schedule
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 20 # of repeats: 0 DPMQ: $16.50 Max safety net: $17.98 General Patient Charge: $20.77
Available brands
AMILOXYN
APO-Amoxycillin
Alphamox 250
Cilamox
Amoxil
*Additional charge for this brand is $4.68
 DPMQ: $21.18 Max safety net: $17.98 General Patient Charge: $25.45

AMOXICILLIN (3302T)

amoxicillin 125 mg/5 mL powder for oral liquid, 100 mL
3302T
Body System:
Manner of administration:Oral
General Schedule
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 0 DPMQ: $19.86 Max safety net: $21.77 General Patient Charge: $24.56
Available brands
APO-Amoxycillin
Amoxycillin Sandoz
Amoxil
*Additional charge for this brand is $4.55
 DPMQ: $24.41 Max safety net: $21.77 General Patient Charge: $29.11

AMOXICILLIN (3393N)

amoxicillin 250 mg/5 mL powder for oral liquid, 100 mL
3393N
Body System:
Manner of administration:Oral
General Schedule
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 0 DPMQ: $19.86 Max safety net: $21.77 General Patient Charge: $24.56
Available brands
AMOXICILLIN-WGR
APO-Amoxycillin
Amoxycillin Sandoz
Amoxil Forte
*Additional charge for this brand is $4.32
 DPMQ: $24.18 Max safety net: $21.77 General Patient Charge: $28.88