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 $38.27 $39.58 $42.50
Available brands
Momasonea
Novasonea
Zatamila
Elocona
* Additional charge for this brand is $17.65B
5 5 5 $55.92 $39.58 $60.15
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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 $33.06 $34.37 $38.91
Available brands
Momasonea
Novasonea
Zatamila
Elocona
* Additional charge for this brand is $14.12B
4 4 5 $47.18 $34.37 $53.03
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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
10819KMPNP MOMETASONE
mometasone furoate 0.1% lotion, 30 mL (PI, CMI)
2 2 5 $22.60 $23.91 $28.45
Available brands
Momasonea
Novasonea
Zatamila
Elocona
* Additional charge for this brand is $7.06B
2 2 5 $29.66 $23.91 $35.51
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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
10826TMPNP MOMETASONE
mometasone furoate 0.1% lotion, 30 mL (PI, CMI)
3 3 5 $27.83 $29.14 $33.68
Available brands
Momasonea
Novasonea
Zatamila
Elocona
* Additional charge for this brand is $10.59B
3 3 5 $38.42 $29.14 $44.27
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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
8043HMPNP MOMETASONE
mometasone furoate 0.1% lotion, 30 mL (PI, CMI)
1 1 0 $17.37 $18.68 $23.22
Available brands
Momasonea
Novasonea
Zatamila
Elocona
* Additional charge for this brand is $3.53B
1 1 0 $20.90 $18.68 $26.75
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  • Legend
  • BBrand premium applies
  • aBrand equivalent a
  • MPMedical Practitioner
  • NPNurse Practitioner