BETAMETHASONE DIPROPIONATE
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 |
10795EMPNP |
BETAMETHASONE DIPROPIONATE betamethasone (as dipropionate) 0.05% ointment, 15 g
(PI,
CMI)
|
2 |
2 |
5 |
$20.83 |
$22.23 |
$25.68 |
Available brands |
Eleuphrata |
Diprosonea * Additional charge for this brand is
$4.90B
|
2 |
2 |
5 |
$25.73 |
$22.23 |
$30.58 |
space
BETAMETHASONE DIPROPIONATE
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 |
10800KMPNP |
BETAMETHASONE DIPROPIONATE betamethasone (as dipropionate) 0.05% cream, 15 g
(PI,
CMI)
|
4 |
4 |
5 |
$28.69 |
$30.09 |
$31.60 |
Available brands |
Eleuphrata |
Diprosonea * Additional charge for this brand is
$9.80B
|
4 |
4 |
5 |
$38.49 |
$30.09 |
$41.40 |
space
BETAMETHASONE DIPROPIONATE
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 |
10801LMPNP |
BETAMETHASONE DIPROPIONATE betamethasone (as dipropionate) 0.05% cream, 15 g
(PI,
CMI)
|
8 |
8 |
5 |
$44.37 |
$31.60 |
$31.60 |
Available brands |
Eleuphrata |
Diprosonea * Additional charge for this brand is
$19.60B
|
8 |
8 |
5 |
$63.97 |
$31.60 |
$51.20 |
space
BETAMETHASONE DIPROPIONATE
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 |
10802MMPNP |
BETAMETHASONE DIPROPIONATE betamethasone (as dipropionate) 0.05% cream, 15 g
(PI,
CMI)
|
10 |
10 |
5 |
$52.17 |
$31.60 |
$31.60 |
Available brands |
Eleuphrata |
Diprosonea * Additional charge for this brand is
$24.50B
|
10 |
10 |
5 |
$76.67 |
$31.60 |
$56.10 |
space
BETAMETHASONE DIPROPIONATE
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 |
10813DMPNP |
BETAMETHASONE DIPROPIONATE betamethasone (as dipropionate) 0.05% cream, 15 g
(PI,
CMI)
|
6 |
6 |
5 |
$36.51 |
$31.60 |
$31.60 |
Available brands |
Eleuphrata |
Diprosonea * Additional charge for this brand is
$14.70B
|
6 |
6 |
5 |
$51.21 |
$31.60 |
$46.30 |
space
BETAMETHASONE DIPROPIONATE
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 |
10816GMPNP |
BETAMETHASONE DIPROPIONATE betamethasone (as dipropionate) 0.05% ointment, 15 g
(PI,
CMI)
|
8 |
8 |
5 |
$44.37 |
$31.60 |
$31.60 |
Available brands |
Eleuphrata |
Diprosonea * Additional charge for this brand is
$19.60B
|
8 |
8 |
5 |
$63.97 |
$31.60 |
$51.20 |
space
BETAMETHASONE DIPROPIONATE
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 |
10820LMPNP |
BETAMETHASONE DIPROPIONATE betamethasone (as dipropionate) 0.05% ointment, 15 g
(PI,
CMI)
|
4 |
4 |
5 |
$28.69 |
$30.09 |
$31.60 |
Available brands |
Eleuphrata |
Diprosonea * Additional charge for this brand is
$9.80B
|
4 |
4 |
5 |
$38.49 |
$30.09 |
$41.40 |
space
BETAMETHASONE DIPROPIONATE
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 |
10821MMPNP |
BETAMETHASONE DIPROPIONATE betamethasone (as dipropionate) 0.05% ointment, 15 g
(PI,
CMI)
|
6 |
6 |
5 |
$36.51 |
$31.60 |
$31.60 |
Available brands |
Eleuphrata |
Diprosonea * Additional charge for this brand is
$14.70B
|
6 |
6 |
5 |
$51.21 |
$31.60 |
$46.30 |
space
BETAMETHASONE DIPROPIONATE
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 |
10823PMPNP |
BETAMETHASONE DIPROPIONATE betamethasone (as dipropionate) 0.05% ointment, 15 g
(PI,
CMI)
|
10 |
10 |
5 |
$52.17 |
$31.60 |
$31.60 |
Available brands |
Eleuphrata |
Diprosonea * Additional charge for this brand is
$24.50B
|
10 |
10 |
5 |
$76.67 |
$31.60 |
$56.10 |
space
BETAMETHASONE DIPROPIONATE
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 |
10824QMPNP |
BETAMETHASONE DIPROPIONATE betamethasone (as dipropionate) 0.05% cream, 15 g
(PI,
CMI)
|
2 |
2 |
5 |
$20.83 |
$22.23 |
$25.68 |
Available brands |
Eleuphrata |
Diprosonea * Additional charge for this brand is
$4.90B
|
2 |
2 |
5 |
$25.73 |
$22.23 |
$30.58 |
space
BETAMETHASONE DIPROPIONATE
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 |
1115QMPNP |
BETAMETHASONE DIPROPIONATE betamethasone (as dipropionate) 0.05% cream, 15 g
(PI,
CMI)
|
1 |
1 |
1 |
$16.91 |
$18.31 |
$21.76 |
Available brands |
Eleuphrata |
Diprosonea * Additional charge for this brand is
$2.45B
|
1 |
1 |
1 |
$19.36 |
$18.31 |
$24.21 |
space
BETAMETHASONE DIPROPIONATE
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 |
1119XMPNP |
BETAMETHASONE DIPROPIONATE betamethasone (as dipropionate) 0.05% ointment, 15 g
(PI,
CMI)
|
1 |
1 |
1 |
$16.91 |
$18.31 |
$21.76 |
Available brands |
Eleuphrata |
Diprosonea * Additional charge for this brand is
$2.45B
|
1 |
1 |
1 |
$19.36 |
$18.31 |
$24.21 |
space
- Legend
- BBrand premium applies
- aBrand equivalent a
- MPMedical Practitioner
- NPNurse Practitioner