Source	General Schedule
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Restricted Benefit

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
2481NMPNP	OXYCODONE oxycodone 30 mg suppository, 12 (PI, CMI)	1	12	0	$51.64	$31.60	$31.60
	Available brands
	Proladone

Source	General Schedule
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Restricted Benefit

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
2622BMPNP	OXYCODONE oxycodone hydrochloride 5 mg tablet, 20 (PI, CMI)	1	20	0	$22.20	$23.68	$27.13
	Available brands
	Mayne Pharma Oxycodone IRa
	Oxycodone Viatrisa
	Oxyndonea
	ENDONEa * Additional charge for this brand is $2.00B	1	20	0	$24.20	$23.68	$29.13

Source	General Schedule
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Restricted Benefit

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
5190EDP	OXYCODONE oxycodone hydrochloride 1 mg/mL oral liquid, 250 mL (PI, CMI)	1	250	0	$32.53	$31.60	$31.60
	Available brands
	OxyNorm Liquid 1mg/mL

Source	General Schedule
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Restricted Benefit

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
5191FDP	OXYCODONE oxycodone hydrochloride 5 mg capsule, 20 (PI, CMI)	1	20	0	$31.12	$31.60	$31.60
	Available brands
	OxyNorma
	Oxycodone BNMa

Source	General Schedule
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Restricted Benefit

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
5194JDP	OXYCODONE oxycodone 30 mg suppository, 12 (PI, CMI)	1	12	0	$51.64	$31.60	$31.60
	Available brands
	Proladone

Source	General Schedule
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Restricted Benefit

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
5195KDP	OXYCODONE oxycodone hydrochloride 5 mg tablet, 20 (PI, CMI)	1	20	0	$22.20	$23.68	$27.13
	Available brands
	Mayne Pharma Oxycodone IRa
	Oxycodone Viatrisa
	Oxyndonea
	ENDONEa * Additional charge for this brand is $2.00B	1	20	0	$24.20	$23.68	$29.13

Source	General Schedule
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Restricted Benefit

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
5197MDP	OXYCODONE oxycodone hydrochloride 10 mg capsule, 20 (PI, CMI)	1	20	0	$25.74	$27.22	$30.67
	Available brands
	OxyNorma
	Oxycodone BNMa

Source	General Schedule
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required (STREAMLINED)

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
8385HMPNP	OXYCODONE oxycodone hydrochloride 10 mg modified release tablet, 28 (PI, CMI)	1	28	0	$30.29	$31.60	$31.60
	Available brands
	OxyContina
	Oxycodone Sandoza

Source	General Schedule
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required (STREAMLINED)

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
8386JMPNP	OXYCODONE oxycodone hydrochloride 20 mg modified release tablet, 28 (PI, CMI)	1	28	0	$38.77	$31.60	$31.60
	Available brands
	OxyContina
	Oxycodone Sandoza

Source	General Schedule
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required (STREAMLINED)

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
8387KMPNP	OXYCODONE oxycodone hydrochloride 40 mg modified release tablet, 28 (PI, CMI)	1	28	0	$48.75	$31.60	$31.60
	Available brands
	OxyContina
	Oxycodone Sandoza

Source	General Schedule
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required (STREAMLINED)

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
8388LMPNP	OXYCODONE oxycodone hydrochloride 80 mg modified release tablet, 28 (PI, CMI)	1	28	0	$67.56	$31.60	$31.60
	Available brands
	OxyContina
	Oxycodone Sandoza

Source	General Schedule
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Restricted Benefit

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
8464LMPNP	OXYCODONE oxycodone hydrochloride 5 mg capsule, 20 (PI, CMI)	1	20	0	$31.12	$31.60	$31.60
	Available brands
	OxyNorma
	Oxycodone BNMa

Source	General Schedule
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Restricted Benefit

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
8501KMPNP	OXYCODONE oxycodone hydrochloride 10 mg capsule, 20 (PI, CMI)	1	20	0	$25.74	$27.22	$30.67
	Available brands
	OxyNorma
	Oxycodone BNMa

Source	General Schedule
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Restricted Benefit

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
8502LMPNP	OXYCODONE oxycodone hydrochloride 20 mg capsule, 20 (PI, CMI)	1	20	0	$31.12	$31.60	$31.60
	Available brands
	OxyNorma
	Oxycodone BNMa

Source	General Schedule
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Restricted Benefit

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
8644YMPNP	OXYCODONE oxycodone hydrochloride 1 mg/mL oral liquid, 250 mL (PI, CMI)	1	250	0	$32.53	$31.60	$31.60
	Available brands
	OxyNorm Liquid 1mg/mL

Source	General Schedule
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required (STREAMLINED)

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
9399QMPNP	OXYCODONE oxycodone hydrochloride 15 mg modified release tablet, 28 (PI, CMI)	1	28	0	$38.53	$31.60	$31.60
	Available brands
	OxyContin

Source	General Schedule
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required (STREAMLINED)

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
9400RMPNP	OXYCODONE oxycodone hydrochloride 30 mg modified release tablet, 28 (PI, CMI)	1	28	0	$52.11	$31.60	$31.60
	Available brands
	OxyContin