FAMOTIDINE

FAMOTIDINE (15047Y)

famotidine 20 mg tablet, 60
15047Y
Body System:
Manner of administration:Oral
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: 120 # of repeats: 5 DPMQ: $22.00 Max safety net: $23.54 General Patient Charge: $25.00
Available brands
Ausfam 20

FAMOTIDINE (15061Q)

famotidine 40 mg tablet, 30
15061Q
Body System:
Manner of administration:Oral
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: 60 # of repeats: 5 DPMQ: $22.00 Max safety net: $23.54 General Patient Charge: $25.00
Available brands
Ausfam 40

FAMOTIDINE (2487X)

famotidine 20 mg tablet, 60
2487X
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: 60 # of repeats: 5 DPMQ: $18.18 Max safety net: $19.72 General Patient Charge: $22.51
Available brands
Ausfam 20

FAMOTIDINE (2488Y)

famotidine 40 mg tablet, 30
2488Y
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: 30 # of repeats: 5 DPMQ: $18.18 Max safety net: $19.72 General Patient Charge: $22.51
Available brands
Ausfam 40