BETAMETHASONE DIPROPIONATE
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 |
10795EMPNP |
BETAMETHASONE DIPROPIONATE betamethasone (as dipropionate) 0.05% ointment, 15 g
(PI,
CMI)
|
2 |
2 |
5 |
$21.31 |
$22.76 |
$26.21 |
Available brands |
Eleuphrata |
Diprosonea * Additional charge for this brand is
$4.90B
|
2 |
2 |
5 |
$26.21 |
$22.76 |
$31.11 |
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BETAMETHASONE DIPROPIONATE
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 |
10816GMPNP |
BETAMETHASONE DIPROPIONATE betamethasone (as dipropionate) 0.05% ointment, 15 g
(PI,
CMI)
|
8 |
8 |
5 |
$44.83 |
$31.60 |
$31.60 |
Available brands |
Eleuphrata |
Diprosonea * Additional charge for this brand is
$19.60B
|
8 |
8 |
5 |
$64.43 |
$31.60 |
$51.20 |
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BETAMETHASONE DIPROPIONATE
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 |
10820LMPNP |
BETAMETHASONE DIPROPIONATE betamethasone (as dipropionate) 0.05% ointment, 15 g
(PI,
CMI)
|
4 |
4 |
5 |
$29.15 |
$30.60 |
$31.60 |
Available brands |
Eleuphrata |
Diprosonea * Additional charge for this brand is
$9.80B
|
4 |
4 |
5 |
$38.95 |
$30.60 |
$41.40 |
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BETAMETHASONE DIPROPIONATE
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 |
10821MMPNP |
BETAMETHASONE DIPROPIONATE betamethasone (as dipropionate) 0.05% ointment, 15 g
(PI,
CMI)
|
6 |
6 |
5 |
$36.99 |
$31.60 |
$31.60 |
Available brands |
Eleuphrata |
Diprosonea * Additional charge for this brand is
$14.70B
|
6 |
6 |
5 |
$51.69 |
$31.60 |
$46.30 |
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BETAMETHASONE DIPROPIONATE
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 |
10823PMPNP |
BETAMETHASONE DIPROPIONATE betamethasone (as dipropionate) 0.05% ointment, 15 g
(PI,
CMI)
|
10 |
10 |
5 |
$52.67 |
$31.60 |
$31.60 |
Available brands |
Eleuphrata |
Diprosonea * Additional charge for this brand is
$24.50B
|
10 |
10 |
5 |
$77.17 |
$31.60 |
$56.10 |
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BETAMETHASONE DIPROPIONATE
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 |
1119XMPNP |
BETAMETHASONE DIPROPIONATE betamethasone (as dipropionate) 0.05% ointment, 15 g
(PI,
CMI)
|
1 |
1 |
1 |
$17.38 |
$18.83 |
$22.28 |
Available brands |
Eleuphrata |
Diprosonea * Additional charge for this brand is
$2.45B
|
1 |
1 |
1 |
$19.83 |
$18.83 |
$24.73 |
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- Legend
- BBrand premium applies
- aBrand equivalent a
- MPMedical Practitioner
- NPNurse Practitioner