Source	General Schedule
Body System	DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN

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
10791YMPNP	MOMETASONE mometasone furoate 0.1% ointment, 15 g (PI, CMI)	10	10	5	$51.38	$25.00	$25.00
	Available brands
	Momasonea
	Novasonea
	Zatamila
	Elocona * Additional charge for this brand is $35.30B	10	10	5	$86.68	$25.00	$60.30

Source	General Schedule
Body System	DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN

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
10793CMPNP	MOMETASONE mometasone furoate 0.1% ointment, 15 g (PI, CMI)	8	8	5	$43.84	$25.00	$25.00
	Available brands
	Momasonea
	Novasonea
	Zatamila
	Elocona * Additional charge for this brand is $28.24B	8	8	5	$72.08	$25.00	$53.24

Source	General Schedule
Body System	DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN

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
10812CMPNP	MOMETASONE mometasone furoate 0.1% ointment, 15 g (PI, CMI)	2	2	5	$21.32	$22.80	$25.00
	Available brands
	Momasonea
	Novasonea
	Zatamila
	Elocona * Additional charge for this brand is $7.06B	2	2	5	$28.38	$22.80	$32.06

Source	General Schedule
Body System	DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN

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
10814EMPNP	MOMETASONE mometasone furoate 0.1% ointment, 15 g (PI, CMI)	4	4	5	$28.84	$25.00	$25.00
	Available brands
	Momasonea
	Novasonea
	Zatamila
	Elocona * Additional charge for this brand is $14.12B	4	4	5	$42.96	$25.00	$39.12

Source	General Schedule
Body System	DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN

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
10828XMPNP	MOMETASONE mometasone furoate 0.1% ointment, 15 g (PI, CMI)	6	6	5	$36.36	$25.00	$25.00
	Available brands
	Momasonea
	Novasonea
	Zatamila
	Elocona * Additional charge for this brand is $21.18B	6	6	5	$57.54	$25.00	$46.18

Source	General Schedule
Body System	DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN

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
1915TMPNP	MOMETASONE mometasone furoate 0.1% ointment, 15 g (PI, CMI)	1	1	0	$17.55	$19.03	$21.82
	Available brands
	Momasonea
	Novasonea
	Zatamila
	Elocona * Additional charge for this brand is $3.53B	1	1	0	$21.08	$19.03	$25.35