Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > BETA-LACTAM ANTIBACTERIALS, PENICILLINS

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
10790XMP	DICLOXACILLIN dicloxacillin 500 mg capsule, 24 (PI, CMI)	2	48	1	$28.34	$29.65	$30.00
	Available brands
	Dicloxacillin Mylan 500a
	Distaph 500a * Additional charge for this brand is $3.90B	2	48	1	$32.24	$29.65	$33.90

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > BETA-LACTAM ANTIBACTERIALS, PENICILLINS

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
5096FDP	DICLOXACILLIN dicloxacillin 250 mg capsule, 24 (PI, CMI)	1	24	0	$16.85	$18.16	$21.45
	Available brands
	Dicloxacillin Mylan 250a
	Distaph 250a * Additional charge for this brand is $1.86B	1	24	0	$18.71	$18.16	$23.31

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > BETA-LACTAM ANTIBACTERIALS, PENICILLINS

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
5097GDP	DICLOXACILLIN dicloxacillin 500 mg capsule, 24 (PI, CMI)	1	24	0	$20.24	$21.55	$24.84
	Available brands
	Dicloxacillin Mylan 500a
	Distaph 500a * Additional charge for this brand is $1.95B	1	24	0	$22.19	$21.55	$26.79

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > BETA-LACTAM ANTIBACTERIALS, PENICILLINS

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
8121KMPMWNP	DICLOXACILLIN dicloxacillin 250 mg capsule, 24 (PI, CMI)	1	24	0	$16.85	$18.16	$21.45
	Available brands
	Dicloxacillin Mylan 250a
	Distaph 250a * Additional charge for this brand is $1.86B	1	24	0	$18.71	$18.16	$23.31

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > BETA-LACTAM ANTIBACTERIALS, PENICILLINS

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
8122LMPMWNP	DICLOXACILLIN dicloxacillin 500 mg capsule, 24 (PI, CMI)	1	24	0	$20.24	$21.55	$24.84
	Available brands
	Dicloxacillin Mylan 500a
	Distaph 500a * Additional charge for this brand is $1.95B	1	24	0	$22.19	$21.55	$26.79