THIAMINE

THIAMINE (1070H)

thiamine hydrochloride 100 mg tablet, 100
1070H
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 5139)

Indication: Thiamine deficiency
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 100 # of repeats: 2 DPMQ: $18.22 Max safety net: $19.76 General Patient Charge: $22.55
Available brands
Betavit

THIAMINE (13354W)

thiamine hydrochloride 100 mg tablet, 100
13354W
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 14319)

Indication: Thiamine deficiency
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 200 # of repeats: 2 DPMQ: $22.08 Max safety net: $23.62 General Patient Charge: $25.00
Available brands
Betavit

THIAMINE (14182K)

thiamine hydrochloride 100 mg tablet, 100
14182K
Body System:
Manner of administration:Oral
Repatriation Pharmaceutical Benefits
Restricted Benefit

Restriction

Indication: The condition must be stable for the prescriber to consider the listed maximum quantity of this medicine suitable for this patient.
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 200 # of repeats: 2 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Betavit DPMQ: $22.08 Max safety net: $7.70 General Patient Charge: $7.70

THIAMINE (4043T)

thiamine hydrochloride 100 mg tablet, 100
4043T
Body System:
Manner of administration:Oral
Repatriation Pharmaceutical Benefits
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 100 # of repeats: 2 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Betavit DPMQ: $18.22 Max safety net: $7.70 General Patient Charge: $7.70