Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

Note

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10777FMP	DOXYCYCLINE doxycycline 100 mg modified release capsule, 7 (PI, CMI)
	Available brands
	Doryxa * Additional charge for this brand is $11.80B	4	28	5	$36.03	$25.68	$40.93
	Mayne Pharma Doxycyclinea * Additional charge for this brand is $6.16B	4	28	5	$30.39	$25.68	$35.29

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

Note

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
14443EMP	DOXYCYCLINE doxycycline 100 mg modified release capsule, 7 (PI, CMI)
	Available brands
	Doryxa * Additional charge for this brand is $23.60B	8	56	2	$58.59	$31.60	$55.20
	Mayne Pharma Doxycyclinea * Additional charge for this brand is $12.32B	8	56	2	$47.31	$31.60	$43.92

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

Note

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
14484HMPNP	DOXYCYCLINE doxycycline 50 mg modified release capsule, 25 (PI, CMI)
	Available brands
	Doryxa * Additional charge for this brand is $10.00B	2	50	2	$29.23	$20.68	$34.13
	Mayne Pharma Doxycyclinea * Additional charge for this brand is $5.16B	2	50	2	$24.39	$20.68	$29.29

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

Note

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
2703GMPNP	DOXYCYCLINE doxycycline 100 mg modified release capsule, 7 (PI, CMI)
	Available brands
	Doryxa * Additional charge for this brand is $11.80B	4	28	0	$36.03	$25.68	$40.93
	Mayne Pharma Doxycyclinea * Additional charge for this brand is $6.16B	4	28	0	$30.39	$25.68	$35.29

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

Note

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
2707LMPNP	DOXYCYCLINE doxycycline 50 mg modified release capsule, 25 (PI, CMI)
	Available brands
	Doryxa * Additional charge for this brand is $5.00B	1	25	5	$21.34	$17.79	$26.24
	Mayne Pharma Doxycyclinea * Additional charge for this brand is $2.58B	1	25	5	$18.92	$17.79	$23.82

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

Note

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
2708MMPNP	DOXYCYCLINE doxycycline 100 mg modified release capsule, 7 (PI, CMI)
	Available brands
	Doryxa * Additional charge for this brand is $2.95B	1	7	1	$19.10	$17.60	$24.00
	Mayne Pharma Doxycyclinea * Additional charge for this brand is $1.54B	1	7	1	$17.69	$17.60	$22.59

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

Note

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
2715XMPNP	DOXYCYCLINE doxycycline 100 mg modified release capsule, 21 (PI, CMI)
	Available brands
	Mayne Pharma Doxycyclinea * Additional charge for this brand is $3.22B	1	21	0	$24.74	$22.97	$29.64

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

Note

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
3322WDP	DOXYCYCLINE doxycycline 100 mg modified release capsule, 7 (PI, CMI)
	Available brands
	Doryxa * Additional charge for this brand is $2.95B	1	7	0	$19.10	$17.60	$24.00
	Mayne Pharma Doxycyclinea * Additional charge for this brand is $1.54B	1	7	0	$17.69	$17.60	$22.59