OMEPRAZOLE

OMEPRAZOLE (14432N)

omeprazole 10 mg enteric tablet, 30
14432N
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Gastro-oesophageal reflux disease

Restriction

Indication: Scleroderma oesophagus

Restriction

Indication: Zollinger-Ellison syndrome
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 60 # of repeats: 5 DPMQ: $21.32 Max safety net: $22.80 General Patient Charge: $25.00
Available brands
Losec Tablets

OMEPRAZOLE (14702T)

omeprazole 10 mg enteric tablet, 30
14702T
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Gastro-oesophageal reflux disease
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 30 # of repeats: 5 DPMQ: $17.55 Max safety net: $19.03 General Patient Charge: $21.82
Available brands
Losec Tablets

OMEPRAZOLE (8332M)

omeprazole 10 mg enteric tablet, 30
8332M
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Scleroderma oesophagus

Restriction

Indication: Zollinger-Ellison syndrome
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 30 # of repeats: 5 DPMQ: $17.55 Max safety net: $19.03 General Patient Charge: $21.82
Available brands
Losec Tablets