DAPAGLIFLOZIN + METFORMIN
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 |
10510EMPNP |
DAPAGLIFLOZIN + METFORMIN dapagliflozin 5 mg + metformin hydrochloride 1 g modified release tablet, 56
(PI,
CMI)
|
1 |
56 |
5 |
$59.88 |
$30.00 |
$30.00 |
Available brands |
Xigduo XR 5/1000 |
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DAPAGLIFLOZIN + METFORMIN
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 |
10515KMPNP |
DAPAGLIFLOZIN + METFORMIN dapagliflozin 10 mg + metformin hydrochloride 1 g modified release tablet, 28
(PI,
CMI)
|
1 |
28 |
5 |
$58.47 |
$30.00 |
$30.00 |
Available brands |
Xigduo XR 10/1000 |
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DAPAGLIFLOZIN + METFORMIN
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 |
10516LMPNP |
DAPAGLIFLOZIN + METFORMIN dapagliflozin 10 mg + metformin hydrochloride 500 mg modified release tablet, 28
(PI,
CMI)
|
1 |
28 |
5 |
$57.72 |
$30.00 |
$30.00 |
Available brands |
Xigduo XR 10/500 |
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DAPAGLIFLOZIN + METFORMIN
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 |
11270EMP |
DAPAGLIFLOZIN + METFORMIN dapagliflozin 10 mg + metformin hydrochloride 500 mg modified release tablet, 28
(PI,
CMI)
|
1 |
28 |
5 |
$57.72 |
$30.00 |
$30.00 |
Available brands |
Xigduo XR 10/500 |
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DAPAGLIFLOZIN + METFORMIN
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 |
11300RMP |
DAPAGLIFLOZIN + METFORMIN dapagliflozin 5 mg + metformin hydrochloride 1 g modified release tablet, 56
(PI,
CMI)
|
1 |
56 |
5 |
$59.88 |
$30.00 |
$30.00 |
Available brands |
Xigduo XR 5/1000 |
space
DAPAGLIFLOZIN + METFORMIN
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 |
11313KMP |
DAPAGLIFLOZIN + METFORMIN dapagliflozin 10 mg + metformin hydrochloride 1 g modified release tablet, 28
(PI,
CMI)
|
1 |
28 |
5 |
$58.47 |
$30.00 |
$30.00 |
Available brands |
Xigduo XR 10/1000 |
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- Legend
- MPMedical Practitioner
- NPNurse Practitioner