METHOTREXATE

METHOTREXATE (13882P)

methotrexate 50 mg/2 mL injection, 5 x 2 mL vials
13882P
Body System:
Manner of administration:Injection
General Schedule
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: 10 # of repeats: 5 DPMQ: $68.64 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
DBL Methotrexate

METHOTREXATE (2395C)

methotrexate 50 mg/2 mL injection, 5 x 2 mL vials
2395C
Body System:
Manner of administration:Injection
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: 5 # of repeats: 5 DPMQ: $41.21 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
DBL Methotrexate