CALCITRIOL

CALCITRIOL (13457G)

calcitriol 0.25 microgram capsule, 100
13457G
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 14322)

Indication: Hypocalcaemia

Restriction (Streamlined authority code: 14287)

Indication: Hypoparathyroidism

Restriction (Streamlined authority code: 14231)

Indication: Hypophosphataemic rickets

Restriction (Streamlined authority code: 14296)

Indication: Vitamin D-resistant rickets

Restriction (Streamlined authority code: 14259)

Indication: Established osteoporosis
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: 3 DPMQ: $46.04 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
CALITROL
Calciprox
Sical
Rocaltrol
*Additional charge for this brand is $4.58
 DPMQ: $50.62 Max safety net: $25.00 General Patient Charge: $29.58

CALCITRIOL (2502Q)

calcitriol 0.25 microgram capsule, 100
2502Q
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 5401)

Indication: Hypocalcaemia

Restriction (Streamlined authority code: 5255)

Indication: Hypoparathyroidism

Restriction (Streamlined authority code: 5089)

Indication: Hypophosphataemic rickets

Restriction (Streamlined authority code: 5114)

Indication: Vitamin D-resistant rickets

Restriction (Streamlined authority code: 5402)

Indication: Established osteoporosis
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: 3 DPMQ: $29.91 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
CALITROL
Calciprox
Sical
Rocaltrol
*Additional charge for this brand is $2.29
 DPMQ: $32.20 Max safety net: $25.00 General Patient Charge: $27.29