PILOCARPINE

PILOCARPINE (14523J)

pilocarpine hydrochloride 2% eye drops, 15 mL
14523J
Body System:
Manner of administration:Application To The Eye
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: 2 # of repeats: 5 DPMQ: $26.60 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Isopto Carpine

PILOCARPINE (2596P)

pilocarpine hydrochloride 2% eye drops, 15 mL
2596P
Body System:
Manner of administration:Application To The Eye
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: 1 # of repeats: 5 DPMQ: $20.19 Max safety net: $21.67 General Patient Charge: $24.46
Available brands
Isopto Carpine

PILOCARPINE (5537K)

pilocarpine hydrochloride 2% eye drops, 15 mL
5537K
Body System:
Manner of administration:Application To The Eye
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: 1 # of repeats: 5 DPMQ: $20.19 Max safety net: $21.67 General Patient Charge: $24.46
Available brands
Isopto Carpine