Source	Palliative Care
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

Note

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
11520HMPNP	CLONAZEPAMP clonazepam 500 microgram tablet, 50 (PI, CMI)
	Available brands
	Rivotrila * Additional charge for this brand is $1.84B	2	100	3	$22.42	$22.06	$26.69

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

Note

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
5337XMPNP	CLONAZEPAMP clonazepam 500 microgram tablet, 100 (PI, CMI)	1	100	3	$20.56	$22.04	$24.83
	Available brands
	Paxam 0.5a

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

Note

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
5338YMPNP	CLONAZEPAMP clonazepam 2 mg tablet, 100 (PI, CMI)	1	100	3	$23.28	$24.76	$25.00
	Available brands
	Paxam 2