BIMATOPROST + TIMOLOL

BIMATOPROST + TIMOLOL (10107Y)

bimatoprost 0.03% + timolol 0.5% eye drops, 30 x 0.4 mL ampoules
10107Y
Body System:
Manner of administration:Application To The Eye
General Schedule
Restricted Benefit

Restriction

Indication: Elevated intra-ocular pressure
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 5 DPMQ: $35.11 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
GANfort PF 0.3/5

BIMATOPROST + TIMOLOL (10108B)

bimatoprost 0.03% + timolol 0.5% eye drops, 30 x 0.4 mL ampoules
10108B
Body System:
Manner of administration:Application To The Eye
General Schedule
Restricted Benefit

Restriction

Indication: Elevated intra-ocular pressure
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 5 DPMQ: $35.11 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
GANfort PF 0.3/5

BIMATOPROST + TIMOLOL (14317M)

bimatoprost 0.03% + timolol 0.5% eye drops, 3 mL
14317M
Body System:
Manner of administration:Application To The Eye
General Schedule
Restricted Benefit

Restriction

Indication: Elevated intra-ocular pressure
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 2 # of repeats: 5 DPMQ: $60.98 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Ganfort 0.3/5

BIMATOPROST + TIMOLOL (14351H)

bimatoprost 0.03% + timolol 0.5% eye drops, 30 x 0.4 mL ampoules
14351H
Body System:
Manner of administration:Application To The Eye
General Schedule
Restricted Benefit

Restriction

Indication: Elevated intra-ocular pressure
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 2 # of repeats: 5 DPMQ: $56.44 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
GANfort PF 0.3/5

BIMATOPROST + TIMOLOL (5558M)

bimatoprost 0.03% + timolol 0.5% eye drops, 3 mL
5558M
Body System:
Manner of administration:Application To The Eye
General Schedule
Restricted Benefit

Restriction

Indication: Elevated intra-ocular pressure
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 5 DPMQ: $37.38 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Ganfort 0.3/5

BIMATOPROST + TIMOLOL (9464D)

bimatoprost 0.03% + timolol 0.5% eye drops, 3 mL
9464D
Body System:
Manner of administration:Application To The Eye
General Schedule
Restricted Benefit

Restriction

Indication: Elevated intra-ocular pressure
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 5 DPMQ: $37.38 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Ganfort 0.3/5