Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

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
11760YMPNP	MORPHINEP morphine sulfate pentahydrate 10 mg modified release capsule, 28 (PI, CMI)	1	28	0	$28.77	$25.00	$25.00
	Available brands
	Kapanol

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

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
11761BMPNP	MORPHINEP morphine sulfate pentahydrate 20 mg modified release capsule, 28 (PI, CMI)	1	28	0	$29.67	$25.00	$25.00
	Available brands
	Kapanol

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required (STREAMLINED)

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
12470HMPNP	MORPHINEP morphine hydrochloride trihydrate 50 mg/5 mL injection, 5 x 5 mL ampoules (PI, CMI)	2	10	1	$43.56	$25.00	$25.00
	Available brands
	Morphine Juno

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required (STREAMLINED)

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
12472KMPNP	MORPHINEP morphine hydrochloride trihydrate 10 mg/mL oral liquid, 200 mL (PI, CMI)	2	400	1	$296.54	$25.00	$25.00
	Available brands
	Ordine 10

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

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
12476PMPNP	MORPHINEP morphine sulfate pentahydrate 15 mg modified release tablet, 28 (PI, CMI)	2	56	0	$45.56	$25.00	$25.00
	Available brands
	MS Contin

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

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
12483BMPNP	MORPHINEP morphine sulfate pentahydrate 100 mg modified release tablet, 28 (PI, CMI)	2	56	0	$105.94	$25.00	$25.00
	Available brands
	MS Contin

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

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
12487FMPNP	MORPHINEP morphine sulfate pentahydrate 60 mg modified release capsule, 14 (PI, CMI)	2	28	0	$54.24	$25.00	$25.00
	Available brands
	MS Mono

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

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
12489HMPNP	MORPHINEP morphine sulfate pentahydrate 50 mg modified release capsule, 28 (PI, CMI)	2	56	0	$63.98	$25.00	$25.00
	Available brands
	Kapanol

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

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
12490JMPNP	MORPHINEP morphine sulfate pentahydrate 30 mg modified release capsule, 14 (PI, CMI)	2	28	0	$39.02	$25.00	$25.00
	Available brands
	MS Mono

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

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
12492LMPNP	MORPHINEP morphine sulfate pentahydrate 5 mg modified release tablet, 28 (PI, CMI)	2	56	0	$32.84	$25.00	$25.00
	Available brands
	MS Contin

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required (STREAMLINED)

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
12494NMPNP	MORPHINEP morphine hydrochloride trihydrate 20 mg/mL injection, 5 x 1 mL ampoules (PI, CMI)	2	10	1	$31.96	$25.00	$25.00
	Available brands
	Morphine Juno

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required (STREAMLINED)

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
12499WMPNP	MORPHINEP morphine sulfate pentahydrate 10 mg/mL injection, 5 x 1 mL ampoules (PI, CMI)	2	10	1	$29.22	$25.00	$25.00
	Available brands
	MORPHINE SULFATE 10 mg/1 mL MEDSURGEa

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

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
12500XMPNP	MORPHINEP morphine sulfate pentahydrate 30 mg modified release tablet, 28 (PI, CMI)	2	56	0	$54.28	$25.00	$25.00
	Available brands
	MS Contin

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

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
12501YMPNP	MORPHINEP morphine sulfate pentahydrate 10 mg modified release capsule, 28 (PI, CMI)	2	56	0	$38.26	$25.00	$25.00
	Available brands
	Kapanol

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required (STREAMLINED)

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
12502BMPNP	MORPHINEP morphine hydrochloride trihydrate 10 mg/mL injection, 5 x 1 mL ampoules (PI, CMI)	2	10	1	$27.58	$25.00	$25.00
	Available brands
	Morphine Junoa

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required (STREAMLINED)

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
12503CMPNP	MORPHINEP morphine sulfate pentahydrate 30 mg/mL injection, 5 x 1 mL ampoules (PI, CMI)	2	10	1	$38.94	$25.00	$25.00
	Available brands
	MORPHINE SULFATE 30 mg/1 mL MEDSURGE

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

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
12512MMPNP	MORPHINEP morphine sulfate pentahydrate 120 mg modified release capsule, 14 (PI, CMI)	2	28	0	$80.70	$25.00	$25.00
	Available brands
	MS Mono

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

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
12514PMPNP	MORPHINEP morphine sulfate pentahydrate 90 mg modified release capsule, 14 (PI, CMI)	2	28	0	$61.54	$25.00	$25.00
	Available brands
	MS Mono

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

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
12529KMPNP	MORPHINEP morphine sulfate pentahydrate 100 mg modified release capsule, 28 (PI, CMI)	2	56	0	$103.14	$25.00	$25.00
	Available brands
	Kapanol

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required (STREAMLINED)

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
12537WMPNP	MORPHINEP morphine hydrochloride trihydrate 100 mg/5 mL injection, 5 x 5 mL ampoules (PI, CMI)	2	10	1	$55.66	$25.00	$25.00
	Available brands
	Morphine Juno

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

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
12539YMPNP	MORPHINEP morphine sulfate pentahydrate 20 mg modified release capsule, 28 (PI, CMI)	2	56	0	$40.06	$25.00	$25.00
	Available brands
	Kapanol

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

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
12544FMPNP	MORPHINEP morphine sulfate pentahydrate 60 mg modified release tablet, 28 (PI, CMI)	2	56	0	$80.72	$25.00	$25.00
	Available brands
	MS Contin

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

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
12547JMPNP	MORPHINEP morphine sulfate pentahydrate 10 mg modified release tablet, 28 (PI, CMI)	2	56	0	$33.58	$25.00	$25.00
	Available brands
	MS Contin

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required (STREAMLINED)

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
12548KMPNP	MORPHINEP morphine sulfate pentahydrate 15 mg/mL injection, 5 x 1 mL ampoules (PI, CMI)	2	10	1	$34.74	$25.00	$25.00
	Available brands
	MORPHINE SULFATE 15 mg/1 mL MEDSURGE

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required (STREAMLINED)

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
12549LMPNP	MORPHINEP morphine hydrochloride trihydrate 5 mg/mL oral liquid, 200 mL (PI, CMI)	2	400	1	$194.94	$25.00	$25.00
	Available brands
	Ordine 5

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

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
5391RMPNP	MORPHINEP morphine sulfate pentahydrate 200 mg modified release tablet, 28 (PI, CMI)	2	56	0	$229.50	$25.00	$25.00
	Available brands
	MS Contin

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

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
5393WMPNP	MORPHINEP morphine sulfate pentahydrate 10 mg tablet, 20 (PI, CMI)	1	20	2	$23.81	$25.00	$25.00
	Available brands
	Sevredol

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

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
5394XMPNP	MORPHINEP morphine sulfate pentahydrate 20 mg tablet, 20 (PI, CMI)	1	20	2	$24.56	$25.00	$25.00
	Available brands
	Sevredol