DEXTRAN-70 + HYPROMELLOSE

Source General Schedule
Body System SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS
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
14521GMPNPOP
DEXTRAN-70 + HYPROMELLOSE
dextran-70 0.1% + hypromellose 0.3% eye drops, 15 mL (PI, CMI)
2 2 5 $20.99 $22.44 $25.89
Available brands
Poly-Tearsa
Tears Naturalea
* Additional charge for this brand is $8.00B
2 2 5 $28.99 $22.44 $33.89
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  • Legend
  • BBrand premium applies
  • aBrand equivalent a
  • MPMedical Practitioner
  • NPNurse Practitioner
  • OPOptometrist
  • 60D60-day prescriptions