Source	General Schedule
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

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
1249RMPNP	PHENYTOIN phenytoin 50 mg chewable tablet, 200 (PI, CMI)	1	200	2	$65.64	$31.60	$31.60
	Available brands
	Dilantin Infatabs

Source	General Schedule
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

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
13841LMPNP	PHENYTOIN phenytoin 30 mg/5 mL oral liquid, 500 mL (PI, CMI)	2	2	3	$39.71	$31.60	$31.60
	Available brands
	Dilantin

Source	General Schedule
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

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
13894GMPNP	PHENYTOIN phenytoin 50 mg chewable tablet, 200 (PI, CMI)	2	400	2	$118.03	$31.60	$31.60
	Available brands
	Dilantin Infatabs

Source	General Schedule
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

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
13972JMPNP	PHENYTOIN phenytoin sodium 100 mg capsule, 200 (PI, CMI)	2	400	2	$54.11	$31.60	$31.60
	Available brands
	Dilantin Sodium

Source	General Schedule
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

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
14015PMPNP	PHENYTOIN phenytoin sodium 30 mg capsule, 200 (PI, CMI)	2	400	2	$92.61	$31.60	$31.60
	Available brands
	Dilantin Sodium

Source	General Schedule
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

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
1873NMPNP	PHENYTOIN phenytoin sodium 30 mg capsule, 200 (PI, CMI)	1	200	2	$53.03	$31.60	$31.60
	Available brands
	Dilantin Sodium

Source	General Schedule
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

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
1874PMPNP	PHENYTOIN phenytoin sodium 100 mg capsule, 200 (PI, CMI)	1	200	2	$33.78	$31.60	$31.60
	Available brands
	Dilantin Sodium

Source	General Schedule
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

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
2692QMPNP	PHENYTOIN phenytoin 30 mg/5 mL oral liquid, 500 mL (PI, CMI)	1	1	3	$26.58	$28.03	$31.48
	Available brands
	Dilantin