Source	General Schedule
Body System	ALIMENTARY TRACT AND METABOLISM > ANTIEMETICS AND ANTINAUSEANTS > ANTIEMETICS AND ANTINAUSEANTS

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
1594XMPNP	ONDANSETRON ondansetron 4 mg tablet, 10 (PI, CMI)	1	10	1	$21.55	$22.86	$26.15
	Available brands
	APO-Ondansetrona
	APX-Ondansetrona
	Ondansetron ANa
	Ondansetron APOTEXa
	Ondansetron Mylan Tabletsa
	Ondansetron SZa
	Ondansetron-DRLAa
	Zofrana
	Zotren 4a

Source	General Schedule
Body System	ALIMENTARY TRACT AND METABOLISM > ANTIEMETICS AND ANTINAUSEANTS > ANTIEMETICS AND ANTINAUSEANTS

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
1595YMPNP	ONDANSETRON ondansetron 8 mg tablet, 10 (PI, CMI)	1	10	1	$23.78	$25.09	$28.38
	Available brands
	APO-Ondansetrona
	APX-Ondansetrona
	Ondansetron ANa
	Ondansetron APOTEXa
	Ondansetron Mylan Tabletsa
	Ondansetron SZa
	Ondansetron-DRLAa
	Zofrana
	Zotren 8a

Source	General Schedule
Body System	ALIMENTARY TRACT AND METABOLISM > ANTIEMETICS AND ANTINAUSEANTS > ANTIEMETICS AND ANTINAUSEANTS

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
5470XMPNP	ONDANSETRON ondansetron 4 mg orally disintegrating tablet, 4 (PI, CMI)	1	4	0	$16.05	$17.36	$20.65
	Available brands
	APO-Ondansetron ODTa
	APX-Ondansetron ODTa
	Ondansetron AN ODTa
	Ondansetron Mylan ODTa
	Ondansetron ODT Lupina
	Ondansetron ODT-DRLAa
	Ondansetron SZ ODTa
	Zotren ODTa

Source	General Schedule
Body System	ALIMENTARY TRACT AND METABOLISM > ANTIEMETICS AND ANTINAUSEANTS > ANTIEMETICS AND ANTINAUSEANTS

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
5471YMPNP	ONDANSETRON ondansetron 8 mg orally disintegrating tablet, 4 (PI, CMI)	1	4	0	$16.88	$18.19	$21.48
	Available brands
	APO-Ondansetron ODTa
	APX-Ondansetron ODTa
	Ondansetron AN ODTa
	Ondansetron Mylan ODTa
	Ondansetron ODT Lupina
	Ondansetron ODT-DRLAa
	Ondansetron SZ ODTa
	Zotren ODTa

Source	General Schedule
Body System	ALIMENTARY TRACT AND METABOLISM > ANTIEMETICS AND ANTINAUSEANTS > ANTIEMETICS AND ANTINAUSEANTS

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
5472BMPNP	ONDANSETRON ondansetron 4 mg orally disintegrating tablet, 10 (PI, CMI)	1	10	1	$21.55	$22.86	$26.15
	Available brands
	APO-Ondansetron ODTa
	APX-Ondansetron ODTa
	Ondansetron AN ODTa
	Ondansetron Mylan ODTa
	Ondansetron ODT Lupina
	Ondansetron ODT-DRLAa
	Ondansetron SZ ODTa
	Zotren ODTa

Source	General Schedule
Body System	ALIMENTARY TRACT AND METABOLISM > ANTIEMETICS AND ANTINAUSEANTS > ANTIEMETICS AND ANTINAUSEANTS

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
5473CMPNP	ONDANSETRON ondansetron 8 mg orally disintegrating tablet, 10 (PI, CMI)	1	10	1	$23.78	$25.09	$28.38
	Available brands
	APO-Ondansetron ODTa
	APX-Ondansetron ODTa
	Ondansetron AN ODTa
	Ondansetron Mylan ODTa
	Ondansetron ODT Lupina
	Ondansetron ODT-DRLAa
	Ondansetron SZ ODTa
	Zotren ODTa

Source	Section 100 (CT)
Body System	ALIMENTARY TRACT AND METABOLISM > ANTIEMETICS AND ANTINAUSEANTS > ANTIEMETICS AND ANTINAUSEANTS

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
5848TMP	ONDANSETRON ondansetron 4 mg/5 mL oral liquid, 50 mL (PI, CMI)	1	1	0	$80.78	$30.00	$30.00
	Available brands
	Zofran syrup 50 mL

Source	Section 100 (CT)
Body System	ALIMENTARY TRACT AND METABOLISM > ANTIEMETICS AND ANTINAUSEANTS > ANTIEMETICS AND ANTINAUSEANTS

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
5857GMP	ONDANSETRON ondansetron 4 mg orally disintegrating tablet, 4 (PI, CMI)	1	4	0	$3.50	$4.81	$4.81
	Available brands
	APO-Ondansetron ODTa
	APX-Ondansetron ODTa
	Ondansetron AN ODTa
	Ondansetron Mylan ODTa
	Ondansetron ODT Lupina
	Ondansetron ODT-DRLAa
	Ondansetron SZ ODTa
	Zotren ODTa

Source	Section 100 (CT)
Body System	ALIMENTARY TRACT AND METABOLISM > ANTIEMETICS AND ANTINAUSEANTS > ANTIEMETICS AND ANTINAUSEANTS

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
5858HMP	ONDANSETRON ondansetron 8 mg orally disintegrating tablet, 4 (PI, CMI)	1	4	0	$4.33	$5.64	$5.64
	Available brands
	APO-Ondansetron ODTa
	APX-Ondansetron ODTa
	Ondansetron AN ODTa
	Ondansetron Mylan ODTa
	Ondansetron ODT Lupina
	Ondansetron ODT-DRLAa
	Ondansetron SZ ODTa
	Zotren ODTa

Source	Section 100 (CT)
Body System	ALIMENTARY TRACT AND METABOLISM > ANTIEMETICS AND ANTINAUSEANTS > ANTIEMETICS AND ANTINAUSEANTS

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
5967CMP	ONDANSETRON ondansetron 4 mg tablet, 4 (PI, CMI)	1	4	0	$3.50	$4.81	$4.81
	Available brands
	APO-Ondansetrona
	APX-Ondansetrona
	Ondansetron ANa
	Ondansetron APOTEXa
	Ondansetron Mylan Tabletsa
	Ondansetron SZa
	Ondansetron-DRLAa
	Zofrana
	Zotren 4a

Source	Section 100 (CT)
Body System	ALIMENTARY TRACT AND METABOLISM > ANTIEMETICS AND ANTINAUSEANTS > ANTIEMETICS AND ANTINAUSEANTS

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
5968DMP	ONDANSETRON ondansetron 8 mg tablet, 4 (PI, CMI)	1	4	0	$4.33	$5.64	$5.64
	Available brands
	APO-Ondansetrona
	APX-Ondansetrona
	Ondansetron ANa
	Ondansetron APOTEXa
	Ondansetron Mylan Tabletsa
	Ondansetron SZa
	Ondansetron-DRLAa
	Zofrana
	Zotren 8a

Source	Section 100 (CT)
Body System	ALIMENTARY TRACT AND METABOLISM > ANTIEMETICS AND ANTINAUSEANTS > ANTIEMETICS AND ANTINAUSEANTS

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
5969EMP	ONDANSETRON ondansetron 4 mg wafer, 4 (PI, CMI)
	Available brands
	Zofran Zydisa * Additional charge for this brand is $2.28B	1	4	0	$5.78	$4.81	$7.09

Source	Section 100 (CT)
Body System	ALIMENTARY TRACT AND METABOLISM > ANTIEMETICS AND ANTINAUSEANTS > ANTIEMETICS AND ANTINAUSEANTS

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
5970FMP	ONDANSETRON ondansetron 8 mg wafer, 4 (PI, CMI)
	Available brands
	Zofran Zydisa * Additional charge for this brand is $2.28B	1	4	0	$7.63	$6.66	$8.94

Source	General Schedule
Body System	ALIMENTARY TRACT AND METABOLISM > ANTIEMETICS AND ANTINAUSEANTS > ANTIEMETICS AND ANTINAUSEANTS

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
8224WMPNP	ONDANSETRON ondansetron 4 mg tablet, 4 (PI, CMI)	1	4	0	$16.05	$17.36	$20.65
	Available brands
	APO-Ondansetrona
	APX-Ondansetrona
	Ondansetron ANa
	Ondansetron APOTEXa
	Ondansetron Mylan Tabletsa
	Ondansetron SZa
	Ondansetron-DRLAa
	Zofrana
	Zotren 4a

Source	General Schedule
Body System	ALIMENTARY TRACT AND METABOLISM > ANTIEMETICS AND ANTINAUSEANTS > ANTIEMETICS AND ANTINAUSEANTS

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
8225XMPNP	ONDANSETRON ondansetron 8 mg tablet, 4 (PI, CMI)	1	4	0	$16.88	$18.19	$21.48
	Available brands
	APO-Ondansetrona
	APX-Ondansetrona
	Ondansetron ANa
	Ondansetron APOTEXa
	Ondansetron Mylan Tabletsa
	Ondansetron SZa
	Ondansetron-DRLAa
	Zofrana
	Zotren 8a

Source	General Schedule
Body System	ALIMENTARY TRACT AND METABOLISM > ANTIEMETICS AND ANTINAUSEANTS > ANTIEMETICS AND ANTINAUSEANTS

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
8233HMPNP	ONDANSETRON ondansetron 4 mg/5 mL oral liquid, 50 mL (PI, CMI)	1	1	1	$98.99	$30.00	$30.00
	Available brands
	Zofran syrup 50 mL

Source	General Schedule
Body System	ALIMENTARY TRACT AND METABOLISM > ANTIEMETICS AND ANTINAUSEANTS > ANTIEMETICS AND ANTINAUSEANTS

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
8410PMPNP	ONDANSETRON ondansetron 4 mg wafer, 4 (PI, CMI)
	Available brands
	Zofran Zydisa * Additional charge for this brand is $2.30B	1	4	0	$18.35	$17.36	$22.95

Source	General Schedule
Body System	ALIMENTARY TRACT AND METABOLISM > ANTIEMETICS AND ANTINAUSEANTS > ANTIEMETICS AND ANTINAUSEANTS

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
8411QMPNP	ONDANSETRON ondansetron 8 mg wafer, 4 (PI, CMI)
	Available brands
	Zofran Zydisa * Additional charge for this brand is $2.44B	1	4	0	$20.34	$19.21	$24.94

Source	General Schedule
Body System	ALIMENTARY TRACT AND METABOLISM > ANTIEMETICS AND ANTINAUSEANTS > ANTIEMETICS AND ANTINAUSEANTS

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
8412RMPNP	ONDANSETRON ondansetron 4 mg wafer, 10 (PI, CMI)
	Available brands
	Zofran Zydisa * Additional charge for this brand is $2.46B	1	10	1	$24.01	$22.86	$28.61

Source	General Schedule
Body System	ALIMENTARY TRACT AND METABOLISM > ANTIEMETICS AND ANTINAUSEANTS > ANTIEMETICS AND ANTINAUSEANTS

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
8413TMPNP	ONDANSETRON ondansetron 8 mg wafer, 10 (PI, CMI)
	Available brands
	Zofran Zydisa * Additional charge for this brand is $2.45B	1	10	1	$28.98	$27.84	$32.45

Source	General Schedule
Body System	ALIMENTARY TRACT AND METABOLISM > ANTIEMETICS AND ANTINAUSEANTS > ANTIEMETICS AND ANTINAUSEANTS

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
9441XMPNP	ONDANSETRON ondansetron 4 mg/5 mL oral liquid, 50 mL (PI, CMI)	1	1	0	$98.99	$30.00	$30.00
	Available brands
	Zofran syrup 50 mL