Source	General Schedule
Body System	DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN

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
10792BMPNP	MOMETASONE mometasone furoate 0.1% cream, 15 g (PI, CMI)	10	10	5	$51.07	$31.60	$31.60
	Available brands
	Momasone Alcohol Freea
	Novasonea
	Elocon Alcohol Freea * Additional charge for this brand is $35.30B	10	10	5	$86.37	$31.60	$66.90

Source	General Schedule
Body System	DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN

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
10809XMPNP	MOMETASONE mometasone furoate 0.1% cream, 15 g (PI, CMI)	4	4	5	$28.51	$29.96	$31.60
	Available brands
	Momasone Alcohol Freea
	Novasonea
	Elocon Alcohol Freea * Additional charge for this brand is $14.12B	4	4	5	$42.63	$29.96	$45.72

Source	General Schedule
Body System	DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN

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
10815FMPNP	MOMETASONE mometasone furoate 0.1% cream, 15 g (PI, CMI)	6	6	5	$36.03	$31.60	$31.60
	Available brands
	Momasone Alcohol Freea
	Novasonea
	Elocon Alcohol Freea * Additional charge for this brand is $21.18B	6	6	5	$57.21	$31.60	$52.78

Source	General Schedule
Body System	DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN

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
10818JMPNP	MOMETASONE mometasone furoate 0.1% cream, 15 g (PI, CMI)	8	8	5	$43.55	$31.60	$31.60
	Available brands
	Momasone Alcohol Freea
	Novasonea
	Elocon Alcohol Freea * Additional charge for this brand is $28.24B	8	8	5	$71.79	$31.60	$59.84

Source	General Schedule
Body System	DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN

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
10827WMPNP	MOMETASONE mometasone furoate 0.1% cream, 15 g (PI, CMI)	2	2	5	$20.99	$22.44	$25.89
	Available brands
	Momasone Alcohol Freea
	Novasonea
	Elocon Alcohol Freea * Additional charge for this brand is $7.06B	2	2	5	$28.05	$22.44	$32.95

Source	General Schedule
Body System	DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN

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
1913QMPNP	MOMETASONE mometasone furoate 0.1% cream, 15 g (PI, CMI)	1	1	0	$17.22	$18.67	$22.12
	Available brands
	Momasone Alcohol Freea
	Novasonea
	Elocon Alcohol Freea * Additional charge for this brand is $3.53B	1	1	0	$20.75	$18.67	$25.65