Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

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	$58.26	$25.00	$25.00
	Available brands
	OxyContina
	Oxycodone Sandoza

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

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	$41.30	$25.00	$25.00
	Available brands
	OxyContina
	Oxycodone Sandoza

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

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	$78.22	$25.00	$25.00
	Available brands
	OxyContina
	Oxycodone Sandoza

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

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	$115.84	$25.00	$25.00
	Available brands
	OxyContina
	Oxycodone Sandoza

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

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	$84.94	$25.00	$25.00
	Available brands
	OxyContin

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

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	$57.78	$25.00	$25.00
	Available brands
	OxyContin