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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
---|---|---|---|---|---|---|---|
10819KMPNP | MOMETASONE mometasone furoate 0.1% lotion, 30 mL (PI, CMI) |
2 | 2 | 5 | $23.45 | $24.85 | $28.30 |
Available brands | |||||||
Novasonea | |||||||
Zatamila | |||||||
Elocona * Additional charge for this brand is
$7.06B
|
2 | 2 | 5 | $30.51 | $24.85 | $35.36 |
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 |
---|---|---|---|---|---|---|---|
10826TMPNP | MOMETASONE mometasone furoate 0.1% lotion, 30 mL (PI, CMI) |
3 | 3 | 5 | $28.68 | $30.08 | $31.60 |
Available brands | |||||||
Novasonea | |||||||
Zatamila | |||||||
Elocona * Additional charge for this brand is
$10.59B
|
3 | 3 | 5 | $39.27 | $30.08 | $42.19 |
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 |
---|---|---|---|---|---|---|---|
10827WMPNP | MOMETASONE mometasone furoate 0.1% cream, 15 g (PI, CMI) |
2 | 2 | 5 | $20.51 | $21.91 | $25.36 |
Available brands | |||||||
Momasone Alcohol Freea | |||||||
Novasonea | |||||||
Elocon Alcohol Freea * Additional charge for this brand is
$7.06B
|
2 | 2 | 5 | $27.57 | $21.91 | $32.42 |
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 |
---|---|---|---|---|---|---|---|
10828XMPNP | MOMETASONE mometasone furoate 0.1% ointment, 15 g (PI, CMI) |
6 | 6 | 5 | $35.55 | $31.60 | $31.60 |
Available brands | |||||||
Momasonea | |||||||
Novasonea | |||||||
Zatamila | |||||||
Elocona * Additional charge for this brand is
$21.18B
|
6 | 6 | 5 | $56.73 | $31.60 | $52.78 |
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 |
---|---|---|---|---|---|---|---|
1913QMPNP | MOMETASONE mometasone furoate 0.1% cream, 15 g (PI, CMI) |
1 | 1 | 0 | $16.75 | $18.15 | $21.60 |
Available brands | |||||||
Momasone Alcohol Freea | |||||||
Novasonea | |||||||
Elocon Alcohol Freea * Additional charge for this brand is
$3.53B
|
1 | 1 | 0 | $20.28 | $18.15 | $25.13 |
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 |
---|---|---|---|---|---|---|---|
1915TMPNP | MOMETASONE mometasone furoate 0.1% ointment, 15 g (PI, CMI) |
1 | 1 | 0 | $16.75 | $18.15 | $21.60 |
Available brands | |||||||
Momasonea | |||||||
Novasonea | |||||||
Zatamila | |||||||
Elocona * Additional charge for this brand is
$3.53B
|
1 | 1 | 0 | $20.28 | $18.15 | $25.13 |
MOMETASONE
Source | Repatriation Pharmaceutical Benefits |
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 |
---|---|---|---|---|---|---|---|
4342MMP | MOMETASONER mometasone furoate 0.1% cream, 50 g (PI, CMI) |
||||||
Available brands | |||||||
Elocon Alcohol Free | 1 | 1 | 0 | $36.52 | $7.70 | $7.70 |
MOMETASONE
Source | Repatriation Pharmaceutical Benefits |
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 |
---|---|---|---|---|---|---|---|
4343NMP | MOMETASONER mometasone furoate 0.1% ointment, 50 g (PI, CMI) |
||||||
Available brands | |||||||
Elocon | 1 | 1 | 0 | $36.52 | $7.70 | $7.70 |
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 |
---|---|---|---|---|---|---|---|
8043HMPNP | MOMETASONE mometasone furoate 0.1% lotion, 30 mL (PI, CMI) |
1 | 1 | 0 | $18.22 | $19.62 | $23.07 |
Available brands | |||||||
Novasonea | |||||||
Zatamila | |||||||
Elocona * Additional charge for this brand is
$3.53B
|
1 | 1 | 0 | $21.75 | $19.62 | $26.60 |
- Legend
- RRepatriation Care items
- BBrand premium applies
- aBrand equivalent a
- MPMedical Practitioner
- NPNurse Practitioner