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 $39.93 $31.60 $31.60
Available brands
Novasonea
Zatamila
Elocona
* Additional charge for this brand is $22.50B
5 5 5 $62.43 $31.60 $54.10
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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 $34.72 $31.60 $31.60
Available brands
Novasonea
Zatamila
Elocona
* Additional charge for this brand is $18.00B
4 4 5 $52.72 $31.60 $49.60
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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 $24.26 $25.74 $29.19
Available brands
Novasonea
Zatamila
Elocona
* Additional charge for this brand is $9.00B
2 2 5 $33.26 $25.74 $38.19
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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 $29.49 $30.97 $31.60
Available brands
Novasonea
Zatamila
Elocona
* Additional charge for this brand is $13.50B
3 3 5 $42.99 $30.97 $45.10
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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 $19.02 $20.50 $23.95
Available brands
Novasonea
Zatamila
Elocona
* Additional charge for this brand is $4.50B
1 1 0 $23.52 $20.50 $28.45
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  • Legend
  • BBrand premium applies
  • aBrand equivalent a
  • MPMedical Practitioner
  • NPNurse Practitioner