IMIQUIMOD

Source Repatriation Pharmaceutical Benefits
Body System DERMATOLOGICALS > OTHER DERMATOLOGICAL PREPARATIONS > OTHER DERMATOLOGICAL PREPARATIONS
Code & Prescriber Medicinal Product Pack
(Name, form & strength and pack size)
Max qty packs Max qty units No. of repeats DPMQ Max Safety Net General Patient Charge
10106XMP IMIQUIMODR
imiquimod 5% cream, 2 x 2 g (PI, CMI)
Available brands
Aldara Pumpa 1 1 1 $96.87 $7.70 $7.70
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IMIQUIMOD

Source General Schedule
Body System DERMATOLOGICALS > OTHER DERMATOLOGICAL PREPARATIONS > OTHER DERMATOLOGICAL PREPARATIONS
Code & Prescriber Medicinal Product Pack
(Name, form & strength and pack size)
Max qty packs Max qty units No. of repeats DPMQ Max Safety Net General Patient Charge
2546BMP IMIQUIMOD
imiquimod 5% cream, 12 x 250 mg sachets (PI, CMI)
1 1 1 $88.52 $31.60 $31.60
Available brands
APO-Imiquimoda
Aldiqa
Aldaraa
* Additional charge for this brand is $3.30B
1 1 1 $91.82 $31.60 $34.90
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IMIQUIMOD

Source General Schedule
Body System DERMATOLOGICALS > OTHER DERMATOLOGICAL PREPARATIONS > OTHER DERMATOLOGICAL PREPARATIONS
Code & Prescriber Medicinal Product Pack
(Name, form & strength and pack size)
Max qty packs Max qty units No. of repeats DPMQ Max Safety Net General Patient Charge
2637TMP IMIQUIMOD
imiquimod 5% cream, 2 x 2 g (PI, CMI)
Available brands
Aldara Pumpa
* Additional charge for this brand is $8.35B
1 1 1 $96.87 $31.60 $39.95
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IMIQUIMOD

Source Repatriation Pharmaceutical Benefits
Body System DERMATOLOGICALS > OTHER DERMATOLOGICAL PREPARATIONS > OTHER DERMATOLOGICAL PREPARATIONS
Code & Prescriber Medicinal Product Pack
(Name, form & strength and pack size)
Max qty packs Max qty units No. of repeats DPMQ Max Safety Net General Patient Charge
4134NMP IMIQUIMODR
imiquimod 5% cream, 12 x 250 mg sachets (PI, CMI)
Available brands
Aldaraa 1 1 1 $91.82 $7.70 $7.70
Aldiqa 1 1 1 $88.52 $7.70 $7.70
APO-Imiquimoda 1 1 1 $88.52 $7.70 $7.70
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IMIQUIMOD

Source Repatriation Pharmaceutical Benefits
Body System DERMATOLOGICALS > OTHER DERMATOLOGICAL PREPARATIONS > OTHER DERMATOLOGICAL PREPARATIONS
Code & Prescriber Medicinal Product Pack
(Name, form & strength and pack size)
Max qty packs Max qty units No. of repeats DPMQ Max Safety Net General Patient Charge
4559YMP IMIQUIMODR
imiquimod 5% cream, 12 x 250 mg sachets (PI, CMI)
Available brands
Aldaraa 1 1 1 $91.82 $7.70 $7.70
Aldiqa 1 1 1 $88.52 $7.70 $7.70
APO-Imiquimoda 1 1 1 $88.52 $7.70 $7.70
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  • Legend
  • RRepatriation Care items
  • BBrand premium applies
  • aBrand equivalent a
  • MPMedical Practitioner