OXYCODONE

Source General Schedule
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
12023TMPNP OXYCODONE
oxycodone hydrochloride 5 mg tablet, 20 (PI, CMI)
0.5 10 0 $19.78 $21.09 $25.63
Available brands
Mayne Pharma Oxycodone IRa
Oxycodone Mylana
Oxyndonea
Endonea
* Additional charge for this brand is $1.16B
0.5 10 0 $20.94 $21.09 $26.79
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OXYCODONE

Source General Schedule
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
12031FMPNP OXYCODONE
oxycodone hydrochloride 10 mg capsule, 20 (PI, CMI)
0.5 10 0 $21.31 $22.62 $27.16
Available brands
OxyNorma
Oxycodone BNMa
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OXYCODONE

Source General Schedule
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
12048DDP OXYCODONE
oxycodone hydrochloride 5 mg tablet, 20 (PI, CMI)
0.5 10 0 $19.78 $21.09 $25.63
Available brands
Mayne Pharma Oxycodone IRa
Oxycodone Mylana
Oxyndonea
Endonea
* Additional charge for this brand is $1.16B
0.5 10 0 $20.94 $21.09 $26.79
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OXYCODONE

Source General Schedule
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
12074LDP OXYCODONE
oxycodone hydrochloride 10 mg capsule, 20 (PI, CMI)
0.5 10 0 $21.31 $22.62 $27.16
Available brands
OxyNorma
Oxycodone BNMa
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OXYCODONE

Source General Schedule
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
12311YDP OXYCODONE
oxycodone hydrochloride 5 mg capsule, 10 (PI, CMI)
1 10 0 $19.33 $20.64 $25.18
Available brands
OxyNorm
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OXYCODONE

Source General Schedule
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
12314DMPNP OXYCODONE
oxycodone hydrochloride 5 mg capsule, 10 (PI, CMI)
1 10 0 $19.33 $20.64 $25.18
Available brands
OxyNorm
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OXYCODONE

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
12510KMPNP OXYCODONEP
oxycodone hydrochloride 20 mg modified release tablet, 28 (PI, CMI)
2 56 0 $55.94 $42.50 $42.50
Available brands
OxyContina
Oxycodone Sandoza
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OXYCODONE

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
12518WMPNP OXYCODONEP
oxycodone hydrochloride 10 mg modified release tablet, 28 (PI, CMI)
2 56 0 $38.98 $40.29 $42.50
Available brands
OxyContina
Oxycodone Sandoza
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OXYCODONE

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
12525FMPNP OXYCODONEP
oxycodone hydrochloride 40 mg modified release tablet, 28 (PI, CMI)
2 56 0 $85.40 $42.50 $42.50
Available brands
OxyContina
Oxycodone Sandoza
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OXYCODONE

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
12527HMPNP OXYCODONEP
oxycodone hydrochloride 80 mg modified release tablet, 28 (PI, CMI)
2 56 0 $129.68 $42.50 $42.50
Available brands
OxyContina
Oxycodone Sandoza
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OXYCODONE

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
12538XMPNP OXYCODONEP
oxycodone hydrochloride 30 mg modified release tablet, 28 (PI, CMI)
2 56 0 $82.62 $42.50 $42.50
Available brands
OxyContin
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OXYCODONE

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
12545GMPNP OXYCODONEP
oxycodone hydrochloride 15 mg modified release tablet, 28 (PI, CMI)
2 56 0 $55.46 $42.50 $42.50
Available brands
OxyContin
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OXYCODONE

Source General Schedule
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
2481NMPNP OXYCODONE
oxycodone 30 mg suppository, 12 (PI, CMI)
1 12 0 $49.33 $42.50 $42.50
Available brands
Proladone
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OXYCODONE

Source General Schedule
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
2622BMPNP OXYCODONE
oxycodone hydrochloride 5 mg tablet, 20 (PI, CMI)
1 20 0 $19.20 $20.51 $25.05
Available brands
Mayne Pharma Oxycodone IRa
Oxycodone Mylana
Oxyndonea
Endonea
* Additional charge for this brand is $1.86B
1 20 0 $21.06 $20.51 $26.91
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OXYCODONE

Source General Schedule
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
5190EDP OXYCODONE
oxycodone hydrochloride 1 mg/mL oral liquid, 250 mL (PI, CMI)
1 1 0 $30.22 $31.53 $36.07
Available brands
OxyNorm Liquid 1mg/mL
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OXYCODONE

Source General Schedule
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
5191FDP OXYCODONE
oxycodone hydrochloride 5 mg capsule, 20 (PI, CMI)
1 20 0 $21.27 $22.58 $27.12
Available brands
OxyNorma
Oxycodone BNMa
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OXYCODONE

Source General Schedule
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
5194JDP OXYCODONE
oxycodone 30 mg suppository, 12 (PI, CMI)
1 12 0 $49.33 $42.50 $42.50
Available brands
Proladone
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OXYCODONE

Source General Schedule
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
5195KDP OXYCODONE
oxycodone hydrochloride 5 mg tablet, 20 (PI, CMI)
1 20 0 $19.20 $20.51 $25.05
Available brands
Mayne Pharma Oxycodone IRa
Oxycodone Mylana
Oxyndonea
Endonea
* Additional charge for this brand is $1.86B
1 20 0 $21.06 $20.51 $26.91
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OXYCODONE

Source General Schedule
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
5197MDP OXYCODONE
oxycodone hydrochloride 10 mg capsule, 20 (PI, CMI)
1 20 0 $21.67 $22.98 $27.52
Available brands
OxyNorma
Oxycodone BNMa
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OXYCODONE

Source General Schedule
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
8385HMPNP OXYCODONE
oxycodone hydrochloride 10 mg modified release tablet, 28 (PI, CMI)
1 28 0 $27.98 $29.29 $33.83
Available brands
OxyContina
Oxycodone Sandoza
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OXYCODONE

Source General Schedule
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
8386JMPNP OXYCODONE
oxycodone hydrochloride 20 mg modified release tablet, 28 (PI, CMI)
1 28 0 $36.46 $37.77 $42.31
Available brands
OxyContina
Oxycodone Sandoza
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OXYCODONE

Source General Schedule
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
8387KMPNP OXYCODONE
oxycodone hydrochloride 40 mg modified release tablet, 28 (PI, CMI)
1 28 0 $51.19 $42.50 $42.50
Available brands
OxyContina
Oxycodone Sandoza
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OXYCODONE

Source General Schedule
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
8388LMPNP OXYCODONE
oxycodone hydrochloride 80 mg modified release tablet, 28 (PI, CMI)
1 28 0 $73.03 $42.50 $42.50
Available brands
OxyContina
Oxycodone Sandoza
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OXYCODONE

Source General Schedule
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
8464LMPNP OXYCODONE
oxycodone hydrochloride 5 mg capsule, 20 (PI, CMI)
1 20 0 $21.27 $22.58 $27.12
Available brands
OxyNorma
Oxycodone BNMa
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OXYCODONE

Source General Schedule
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
8501KMPNP OXYCODONE
oxycodone hydrochloride 10 mg capsule, 20 (PI, CMI)
1 20 0 $21.67 $22.98 $27.52
Available brands
OxyNorma
Oxycodone BNMa
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OXYCODONE

Source General Schedule
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
8502LMPNP OXYCODONE
oxycodone hydrochloride 20 mg capsule, 20 (PI, CMI)
1 20 0 $25.02 $26.33 $30.87
Available brands
OxyNorma
Oxycodone BNMa
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OXYCODONE

Source General Schedule
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
8644YMPNP OXYCODONE
oxycodone hydrochloride 1 mg/mL oral liquid, 250 mL (PI, CMI)
1 1 0 $30.22 $31.53 $36.07
Available brands
OxyNorm Liquid 1mg/mL
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OXYCODONE

Source General Schedule
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
9399QMPNP OXYCODONE
oxycodone hydrochloride 15 mg modified release tablet, 28 (PI, CMI)
1 28 0 $36.22 $37.53 $42.07
Available brands
OxyContin
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OXYCODONE

Source General Schedule
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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
9400RMPNP OXYCODONE
oxycodone hydrochloride 30 mg modified release tablet, 28 (PI, CMI)
1 28 0 $49.80 $42.50 $42.50
Available brands
OxyContin
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  • Legend
  • PPalliative care items
  • BBrand premium applies
  • aBrand equivalent a
  • DPDentist
  • MPMedical Practitioner
  • NPNurse Practitioner