Source	General Schedule
Body System	MUSCULO-SKELETAL SYSTEM > ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS > ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS, NON-STEROIDS

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
2454EMPNP	INDOMETACIN indometacin 25 mg capsule, 50 (PI, CMI)	2	100	3	$19.65	$21.05	$24.50
	Available brands
	Arthrexina
	Indocida * Additional charge for this brand is $4.04B	2	100	3	$23.69	$21.05	$28.54

Source	General Schedule
Body System	MUSCULO-SKELETAL SYSTEM > ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS > ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS, NON-STEROIDS

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
5126TDP	INDOMETACIN indometacin 25 mg capsule, 50 (PI, CMI)	2	100	0	$19.65	$21.05	$24.50
	Available brands
	Arthrexina
	Indocida * Additional charge for this brand is $4.04B	2	100	0	$23.69	$21.05	$28.54

Source	Palliative Care
Body System	MUSCULO-SKELETAL SYSTEM > ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS > ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS, NON-STEROIDS

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
5377BMPNP	INDOMETACINP indometacin 25 mg capsule, 50 (PI, CMI)	2	100	3	$19.65	$21.05	$24.50
	Available brands
	Arthrexina
	Indocida * Additional charge for this brand is $4.04B	2	100	3	$23.69	$21.05	$28.54