TRIMETHOPRIM + SULFAMETHOXAZOLE
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 |
10784NMP |
TRIMETHOPRIM + SULFAMETHOXAZOLE trimethoprim 160 mg + sulfamethoxazole 800 mg tablet, 10
(PI,
CMI)
|
3 |
30 |
2 |
$20.21 |
$21.52 |
$24.81 |
Available brands |
Bactrim DSa |
Resprim Fortea |
Septrin Fortea * Additional charge for this brand is
$12.51B
|
3 |
30 |
2 |
$32.72 |
$21.52 |
$37.32 |
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TRIMETHOPRIM + SULFAMETHOXAZOLE
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 |
2951HMPNP |
TRIMETHOPRIM + SULFAMETHOXAZOLE trimethoprim 160 mg + sulfamethoxazole 800 mg tablet, 10
(PI,
CMI)
|
1 |
10 |
1 |
$14.83 |
$16.14 |
$19.43 |
Available brands |
Bactrim DSa |
Resprim Fortea |
Septrin Fortea * Additional charge for this brand is
$4.17B
|
1 |
10 |
1 |
$19.00 |
$16.14 |
$23.60 |
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TRIMETHOPRIM + SULFAMETHOXAZOLE
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 |
3103HMPNP |
TRIMETHOPRIM + SULFAMETHOXAZOLE trimethoprim 40 mg/5 mL + sulfamethoxazole 200 mg/5 mL oral liquid, 100 mL
(PI,
CMI)
|
1 |
1 |
1 |
$20.44 |
$21.75 |
$25.04 |
Available brands |
Septrin |
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TRIMETHOPRIM + SULFAMETHOXAZOLE
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 |
3390KDP |
TRIMETHOPRIM + SULFAMETHOXAZOLE trimethoprim 160 mg + sulfamethoxazole 800 mg tablet, 10
(PI,
CMI)
|
1 |
10 |
0 |
$14.83 |
$16.14 |
$19.43 |
Available brands |
Bactrim DSa |
Resprim Fortea |
Septrin Fortea * Additional charge for this brand is
$4.17B
|
1 |
10 |
0 |
$19.00 |
$16.14 |
$23.60 |
space
TRIMETHOPRIM + SULFAMETHOXAZOLE
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 |
3391LDP |
TRIMETHOPRIM + SULFAMETHOXAZOLE trimethoprim 40 mg/5 mL + sulfamethoxazole 200 mg/5 mL oral liquid, 100 mL
(PI,
CMI)
|
1 |
1 |
0 |
$20.44 |
$21.75 |
$25.04 |
Available brands |
Septrin |
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- Legend
- BBrand premium applies
- aBrand equivalent a
- DPDentist
- MPMedical Practitioner
- NPNurse Practitioner