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 |
---|---|---|---|---|---|---|---|
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 |
---|---|---|---|---|---|---|---|
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
- BBrand premium applies
- aBrand equivalent a
- MPMedical Practitioner
- NPNurse Practitioner