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
space

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
1509KMPNP DEXTRAN-70 + HYPROMELLOSE
dextran-70 0.1% + hypromellose 0.3% eye drops, 15 mL (PI, CMI) 		1 1 5 $17.22 $18.67 $22.12
Available brands
Poly-Tearsa
Tears Naturalea
* Additional charge for this brand is $4.00B
 1 1 5 $21.22 $18.67 $26.12
space

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
5520MOP DEXTRAN-70 + HYPROMELLOSE
dextran-70 0.1% + hypromellose 0.3% eye drops, 15 mL (PI, CMI) 		1 1 5 $17.22 $18.67 $22.12
Available brands
Poly-Tearsa
Tears Naturalea
* Additional charge for this brand is $4.00B
 1 1 5 $21.22 $18.67 $26.12
space

DEXTRAN-70 + HYPROMELLOSE SO
Products that are in a Supply Only state will be available for dispensing, but not for prescribing. PBS Prescriptions written prior to the Supply Only period are able to be dispensed using either the Supply Only product where available, or an equivalent product as specified on the PBS schedule.
Supply only until 01/09/2025

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
9216CMP DEXTRAN-70 + HYPROMELLOSE
dextran-70 0.1% + hypromellose 0.3% eye drops, 15 mL (PI, CMI) 		1 1 11 $17.22 $18.67 $26.12
Available brands
Poly-Tears SO
Products that are in a Supply Only state will be available for dispensing, but not for prescribing. PBS Prescriptions written prior to the Supply Only period are able to be dispensed using either the Supply Only product where available, or an equivalent product as specified on the PBS schedule.
Supply onlya
Tears Naturale SO
Products that are in a Supply Only state will be available for dispensing, but not for prescribing. PBS Prescriptions written prior to the Supply Only period are able to be dispensed using either the Supply Only product where available, or an equivalent product as specified on the PBS schedule.
Supply onlya
* Additional charge for this brand is $4.00B
 1 1 11 $21.22 $18.67 $26.12
space


  • Legend
  • BBrand premium applies
  • aBrand equivalent a
  • MPMedical Practitioner
  • NPNurse Practitioner
  • OPOptometrist
  • SO
    Products that are in a Supply Only state will be available for dispensing, but not for prescribing. PBS Prescriptions written prior to the Supply Only period are able to be dispensed using either the Supply Only product where available, or an equivalent product as specified on the PBS schedule.
    Supply Only
  • 60D60-day prescriptions