Source	Prescriber Bag
Body System	NERVOUS SYSTEM > ANESTHETICS > ANESTHETICS, LOCAL

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
10209HMPMWNP	LIDOCAINE lidocaine hydrochloride monohydrate 1% (50 mg/5 mL) injection, 5 x 5 mL ampoules (PI, CMI)	1	5	0	$50.90	$0.00	Nil
	Available brands
	LIGNOCAINE INJECTION (BRIDGEWEST)

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > CARDIAC THERAPY > ANTIARRHYTHMICS, CLASS I AND III

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
2876JMPNP	LIDOCAINE lidocaine hydrochloride 10% (500 mg/5 mL) injection, 10 x 5 mL ampoules (PI, CMI)	1	10	0	$35.56	$31.60	$31.60
	Available brands
	Xylocard 500

Source	Repatriation Pharmaceutical Benefits
Body System	DERMATOLOGICALS > ANTIPRURITICS, INCL. ANTIHISTAMINES, ANESTHETICS, ETC. > ANTIPRURITICS, INCL. ANTIHISTAMINES, ANESTHETICS, ETC.

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
4308RMP	LIDOCAINER lidocaine hydrochloride 2% oral liquid, 200 mL (PI, CMI)
	Available brands
	Xylocaine Viscous	1	1	0	$105.58	$7.70	$7.70