LATANOPROST + TIMOLOL

LATANOPROST + TIMOLOL (14350G)

latanoprost 0.005% + timolol 0.5% eye drops, 2.5 mL
14350G
Body System:
Manner of administration:Application To The Eye
General Schedule
Restricted Benefit

Restriction

Indication: Elevated intra-ocular pressure
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: $30.10 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
APO-Latanoprost/Timolol 0.05/5
Xalacom
Xalamol 50/5

LATANOPROST + TIMOLOL (5553G)

latanoprost 0.005% + timolol 0.5% eye drops, 2.5 mL
5553G
Body System:
Manner of administration:Application To The Eye
General Schedule
Restricted Benefit

Restriction

Indication: Elevated intra-ocular pressure
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: $21.94 Max safety net: $23.42 General Patient Charge: $25.00
Available brands
APO-Latanoprost/Timolol 0.05/5
Xalacom
Xalamol 50/5

LATANOPROST + TIMOLOL (8895E)

latanoprost 0.005% + timolol 0.5% eye drops, 2.5 mL
8895E
Body System:
Manner of administration:Application To The Eye
General Schedule
Restricted Benefit

Restriction

Indication: Elevated intra-ocular pressure
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: $21.94 Max safety net: $23.42 General Patient Charge: $25.00
Available brands
APO-Latanoprost/Timolol 0.05/5
Xalacom
Xalamol 50/5