Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

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
11852TMPNP	CARMELLOSE SODIUM carmellose sodium 0.5% eye drops, 10 mL (PI, CMI)	1	1	5	$25.01	$26.46	$29.91
	Available brands
	Evolve Carmellose

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

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
11853WOP	CARMELLOSE SODIUM carmellose sodium 0.5% eye drops, 10 mL (PI, CMI)	1	1	5	$25.01	$26.46	$29.91
	Available brands
	Evolve Carmellose

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

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
14319PMPNPOP	CARMELLOSE SODIUM carmellose sodium 0.5% eye drops, 10 mL (PI, CMI)	2	2	5	$36.57	$31.60	$31.60
	Available brands
	Evolve Carmellose

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

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
14452PMPNPOP	CARMELLOSE SODIUM carmellose sodium 1% eye drops, 30 x 0.4 mL ampoules (PI, CMI)	6	6	5	$40.83	$31.60	$31.60
	Available brands
	Celluvisc

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

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
14522HMPNPOP	CARMELLOSE SODIUM carmellose sodium 0.5% eye drops, 30 x 0.4 mL ampoules (PI, CMI)	6	6	5	$40.83	$31.60	$31.60
	Available brands
	Cellufresh

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

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
2324HMPNP	CARMELLOSE SODIUM carmellose sodium 1% eye drops, 30 x 0.4 mL ampoules (PI, CMI)	3	3	5	$27.15	$28.60	$31.60
	Available brands
	Celluvisc

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

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
2338CMPNP	CARMELLOSE SODIUM carmellose sodium 0.5% eye drops, 30 x 0.4 mL ampoules (PI, CMI)	3	3	5	$27.15	$28.60	$31.60
	Available brands
	Cellufresh

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

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
5505ROP	CARMELLOSE SODIUM carmellose sodium 1% eye drops, 30 x 0.4 mL ampoules (PI, CMI)	3	3	5	$27.15	$28.60	$31.60
	Available brands
	Celluvisc

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

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
5506TOP	CARMELLOSE SODIUM carmellose sodium 0.5% eye drops, 30 x 0.4 mL ampoules (PI, CMI)	3	3	5	$27.15	$28.60	$31.60
	Available brands
	Cellufresh

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

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
5507WOP	CARMELLOSE SODIUM carmellose sodium 0.5% eye drops, 15 mL (PI, CMI)	1	1	5	$16.61	$18.06	$21.51
	Available brands
	Refresh Tears Plus SO Products that are in a Supply Only state will be available for dispensing, but not for prescribing. PBS Prescriptions written prior to the Supply Only period are able to be dispensed using either the Supply Only product where available, or an equivalent product as specified on the PBS schedule. Supply only

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

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
5508XOP	CARMELLOSE SODIUM carmellose sodium 1% eye drops, 15 mL (PI, CMI)	1	1	5	$16.61	$18.06	$21.51
	Available brands
	Refresh Liquigel SO Products that are in a Supply Only state will be available for dispensing, but not for prescribing. PBS Prescriptions written prior to the Supply Only period are able to be dispensed using either the Supply Only product where available, or an equivalent product as specified on the PBS schedule. Supply only

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

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
8548XMPNP	CARMELLOSE SODIUM carmellose sodium 0.5% eye drops, 15 mL (PI, CMI)	1	1	5	$16.61	$18.06	$21.51
	Available brands
	Refresh Tears Plus SO Products that are in a Supply Only state will be available for dispensing, but not for prescribing. PBS Prescriptions written prior to the Supply Only period are able to be dispensed using either the Supply Only product where available, or an equivalent product as specified on the PBS schedule. Supply only

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

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
8593GMPNP	CARMELLOSE SODIUM carmellose sodium 1% eye drops, 15 mL (PI, CMI)	1	1	5	$16.61	$18.06	$21.51
	Available brands
	Refresh Liquigel SO Products that are in a Supply Only state will be available for dispensing, but not for prescribing. PBS Prescriptions written prior to the Supply Only period are able to be dispensed using either the Supply Only product where available, or an equivalent product as specified on the PBS schedule. Supply only

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

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
9211TMP	CARMELLOSE SODIUM carmellose sodium 0.5% eye drops, 15 mL (PI, CMI)	1	1	11	$16.61	$18.06	$21.51
	Available brands
	Refresh Tears Plus SO Products that are in a Supply Only state will be available for dispensing, but not for prescribing. PBS Prescriptions written prior to the Supply Only period are able to be dispensed using either the Supply Only product where available, or an equivalent product as specified on the PBS schedule. Supply only

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

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
9212WMP	CARMELLOSE SODIUM carmellose sodium 1% eye drops, 15 mL (PI, CMI)	1	1	11	$16.61	$18.06	$21.51
	Available brands
	Refresh Liquigel SO Products that are in a Supply Only state will be available for dispensing, but not for prescribing. PBS Prescriptions written prior to the Supply Only period are able to be dispensed using either the Supply Only product where available, or an equivalent product as specified on the PBS schedule. Supply only