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 |
- Legend
- BBrand premium applies
- aBrand equivalent a
- MPMedical Practitioner
- NPNurse Practitioner
- OPOptometrist
- 60D60-day prescriptions
