Source	General Schedule
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

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
11703YMPNP	ETHOSUXIMIDE ethosuximide 250 mg capsule, 100 (PI, CMI)	2	200	2	$296.66	$31.60	$31.60
	Available brands
	ZARONTIN

Source	General Schedule
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

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
14014NMPNP	ETHOSUXIMIDE ethosuximide 250 mg/5 mL oral liquid, 200 mL (PI, CMI)	2	2	5	$136.02	$31.60	$31.60
	Available brands
	Zarontin

Source	General Schedule
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

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
1414KMPNP	ETHOSUXIMIDE ethosuximide 250 mg/5 mL oral liquid, 200 mL (PI, CMI)	1	1	5	$74.38	$31.60	$31.60
	Available brands
	Zarontin