Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

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
10176NMPNP	DOXYCYCLINE doxycycline 100 mg tablet, 21 (PI, CMI)	1	21	0	$21.85	$23.33	$26.78
	Available brands
	APX-Doxycyclinea
	Doxsiga
	Doxylin 100a

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

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
10777FMPNP	DOXYCYCLINE doxycycline 100 mg modified release capsule, 7 (PI, CMI)
	Available brands
	Doryxa * Additional charge for this brand is $11.80B	4	28	5	$36.36	$26.04	$41.29
	Mayne Pharma Doxycyclinea * Additional charge for this brand is $6.16B	4	28	5	$30.72	$26.04	$35.65

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

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
10779HMPNP	DOXYCYCLINE doxycycline 100 mg tablet, 7 (PI, CMI)	4	28	5	$24.56	$26.04	$29.49
	Available brands
	APX-Doxycyclinea
	DOXYCYCLINE-WGRa
	Doxsiga
	Doxylin 100a

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

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
10781KMPNP	DOXYCYCLINE doxycycline 100 mg tablet, 7 (PI, CMI)	4	28	5	$24.56	$26.04	$29.49
	Available brands
	Doxycycline Sandoza

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

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
2702FMPNP	DOXYCYCLINE doxycycline 100 mg tablet, 7 (PI, CMI)	4	28	0	$24.56	$26.04	$29.49
	Available brands
	APX-Doxycyclinea
	DOXYCYCLINE-WGRa
	Doxsiga
	Doxylin 100a

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

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
2703GMPNP	DOXYCYCLINE doxycycline 100 mg modified release capsule, 7 (PI, CMI)
	Available brands
	Doryxa * Additional charge for this brand is $11.80B	4	28	0	$36.36	$26.04	$41.29
	Mayne Pharma Doxycyclinea * Additional charge for this brand is $6.16B	4	28	0	$30.72	$26.04	$35.65

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

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
2707LMPNP	DOXYCYCLINE doxycycline 50 mg modified release capsule, 25 (PI, CMI)
	Available brands
	Doryxa * Additional charge for this brand is $5.00B	1	25	5	$21.67	$18.15	$26.60
	Mayne Pharma Doxycyclinea * Additional charge for this brand is $2.58B	1	25	5	$19.25	$18.15	$24.18

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

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
2708MMPMWNP	DOXYCYCLINE doxycycline 100 mg modified release capsule, 7 (PI, CMI)
	Available brands
	Doryxa * Additional charge for this brand is $2.95B	1	7	1	$19.43	$17.96	$24.36
	Mayne Pharma Doxycyclinea * Additional charge for this brand is $1.54B	1	7	1	$18.02	$17.96	$22.95

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

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
2709NMPMWNP	DOXYCYCLINE doxycycline 100 mg tablet, 7 (PI, CMI)	1	7	1	$16.48	$17.96	$21.41
	Available brands
	APX-Doxycyclinea
	DOXYCYCLINE-WGRa
	Doxsiga
	Doxylin 100a

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

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
2711QMPNP	DOXYCYCLINE doxycycline 50 mg tablet, 25 (PI, CMI)	1	25	5	$16.67	$18.15	$21.60
	Available brands
	APX-Doxycyclinea
	DOXYCYCLINE-WGRa
	Doxsiga
	Doxylin 50a

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

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
2714WMPNP	DOXYCYCLINE doxycycline 100 mg tablet, 7 (PI, CMI)	3	21	0	$21.87	$23.35	$26.80
	Available brands
	APX-Doxycyclinea
	DOXYCYCLINE-WGRa
	Doxsiga
	Doxylin 100a

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

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
2715XMPNP	DOXYCYCLINE doxycycline 100 mg modified release capsule, 21 (PI, CMI)
	Available brands
	Mayne Pharma Doxycyclinea * Additional charge for this brand is $3.22B	1	21	0	$25.07	$23.33	$30.00

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

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
3321TDP	DOXYCYCLINE doxycycline 100 mg tablet, 7 (PI, CMI)	1	7	0	$16.48	$17.96	$21.41
	Available brands
	APX-Doxycyclinea
	DOXYCYCLINE-WGRa
	Doxsiga
	Doxylin 100a

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

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
3322WDP	DOXYCYCLINE doxycycline 100 mg modified release capsule, 7 (PI, CMI)
	Available brands
	Doryxa * Additional charge for this brand is $2.95B	1	7	0	$19.43	$17.96	$24.36
	Mayne Pharma Doxycyclinea * Additional charge for this brand is $1.54B	1	7	0	$18.02	$17.96	$22.95

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

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
5082LDP	DOXYCYCLINE doxycycline 100 mg tablet, 7 (PI, CMI)	1	7	0	$16.48	$17.96	$21.41
	Available brands
	Doxycycline Sandoza

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

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
9105FMPMWNP	DOXYCYCLINE doxycycline 100 mg tablet, 7 (PI, CMI)	1	7	1	$16.48	$17.96	$21.41
	Available brands
	Doxycycline Sandoza

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

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
9106GMPNP	DOXYCYCLINE doxycycline 50 mg tablet, 25 (PI, CMI)	1	25	5	$16.67	$18.15	$21.60
	Available brands
	Doxycycline Sandoza

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

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
9107HMPNP	DOXYCYCLINE doxycycline 100 mg tablet, 7 (PI, CMI)	4	28	0	$24.56	$26.04	$29.49
	Available brands
	Doxycycline Sandoza

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > TETRACYCLINES

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
9108JMPNP	DOXYCYCLINE doxycycline 100 mg tablet, 7 (PI, CMI)	3	21	0	$21.87	$23.35	$26.80
	Available brands
	Doxycycline Sandoza