LEVONORGESTREL + ETHINYLESTRADIOL

LEVONORGESTREL + ETHINYLESTRADIOL (1392G)

levonorgestrel 50 microgram + ethinylestradiol 30 microgram tablet [6] (&) levonorgestrel 75 microgram + ethinylestradiol 40 microgram tablet [5] (&) levonorgestrel 125 microgram + ethinylestradiol 30 microgram tablet [10] (&) inert substance tablet [7], 4 x 28
1392G
Body System:
Manner of administration:Oral
General Schedule
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: 4 # of repeats: 2 DPMQ: $21.51 Max safety net: $22.99 General Patient Charge: $25.00
Available brands
Logynon ED
Trifeme 28
Triquilar ED
*Additional charge for this brand is $13.56
 DPMQ: $35.07 Max safety net: $22.99 General Patient Charge: $38.56