MOMETASONE

Source General Schedule
Body System DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN
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
10791YMPNP MOMETASONE
mometasone furoate 0.1% ointment, 15 g (PI, CMI)
10 10 5 $50.57 $31.60 $31.60
Available brands
Momasonea
Novasonea
Zatamila
Elocona
* Additional charge for this brand is $35.30B
10 10 5 $85.87 $31.60 $66.90
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MOMETASONE

Source General Schedule
Body System DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN
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
10792BMPNP MOMETASONE
mometasone furoate 0.1% cream, 15 g (PI, CMI)
10 10 5 $50.57 $31.60 $31.60
Available brands
Momasone Alcohol Freea
Novasonea
Elocon Alcohol Freea
* Additional charge for this brand is $35.30B
10 10 5 $85.87 $31.60 $66.90
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MOMETASONE

Source General Schedule
Body System DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN
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
10793CMPNP MOMETASONE
mometasone furoate 0.1% ointment, 15 g (PI, CMI)
8 8 5 $43.09 $31.60 $31.60
Available brands
Momasonea
Novasonea
Zatamila
Elocona
* Additional charge for this brand is $28.24B
8 8 5 $71.33 $31.60 $59.84
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MOMETASONE

Source General Schedule
Body System DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN
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
10804PMPNP MOMETASONE
mometasone furoate 0.1% lotion, 30 mL (PI, CMI)
5 5 5 $39.12 $31.60 $31.60
Available brands
Novasonea
Zatamila
Elocona
* Additional charge for this brand is $17.65B
5 5 5 $56.77 $31.60 $49.25
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MOMETASONE

Source General Schedule
Body System DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN
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
10805QMPNP MOMETASONE
mometasone furoate 0.1% lotion, 30 mL (PI, CMI)
4 4 5 $33.93 $31.60 $31.60
Available brands
Novasonea
Zatamila
Elocona
* Additional charge for this brand is $14.12B
4 4 5 $48.05 $31.60 $45.72
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MOMETASONE

Source General Schedule
Body System DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN
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
10809XMPNP MOMETASONE
mometasone furoate 0.1% cream, 15 g (PI, CMI)
4 4 5 $28.05 $29.45 $31.60
Available brands
Momasone Alcohol Freea
Novasonea
Elocon Alcohol Freea
* Additional charge for this brand is $14.12B
4 4 5 $42.17 $29.45 $45.72
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MOMETASONE

Source General Schedule
Body System DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN
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
10812CMPNP MOMETASONE
mometasone furoate 0.1% ointment, 15 g (PI, CMI)
2 2 5 $20.51 $21.91 $25.36
Available brands
Momasonea
Novasonea
Zatamila
Elocona
* Additional charge for this brand is $7.06B
2 2 5 $27.57 $21.91 $32.42
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MOMETASONE

Source General Schedule
Body System DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN
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
10814EMPNP MOMETASONE
mometasone furoate 0.1% ointment, 15 g (PI, CMI)
4 4 5 $28.05 $29.45 $31.60
Available brands
Momasonea
Novasonea
Zatamila
Elocona
* Additional charge for this brand is $14.12B
4 4 5 $42.17 $29.45 $45.72
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MOMETASONE

Source General Schedule
Body System DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN
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
10815FMPNP MOMETASONE
mometasone furoate 0.1% cream, 15 g (PI, CMI)
6 6 5 $35.55 $31.60 $31.60
Available brands
Momasone Alcohol Freea
Novasonea
Elocon Alcohol Freea
* Additional charge for this brand is $21.18B
6 6 5 $56.73 $31.60 $52.78
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MOMETASONE

Source General Schedule
Body System DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN
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
10818JMPNP MOMETASONE
mometasone furoate 0.1% cream, 15 g (PI, CMI)
8 8 5 $43.09 $31.60 $31.60
Available brands
Momasone Alcohol Freea
Novasonea
Elocon Alcohol Freea
* Additional charge for this brand is $28.24B
8 8 5 $71.33 $31.60 $59.84
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  • Legend
  • BBrand premium applies
  • aBrand equivalent a
  • MPMedical Practitioner
  • NPNurse Practitioner