Source	General Schedule
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
12045YDP	HYDROMORPHONE hydromorphone hydrochloride 2 mg tablet, 20 (PI, CMI)	0.5	10	0	$24.87	$26.35	$29.80
	Available brands
	Dilaudid

Source	General Schedule
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
12047CMPNP	HYDROMORPHONE hydromorphone hydrochloride 2 mg tablet, 20 (PI, CMI)	0.5	10	0	$24.87	$26.35	$29.80
	Available brands
	Dilaudid

Source	General Schedule
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
5115FDP	HYDROMORPHONE hydromorphone hydrochloride 2 mg tablet, 20 (PI, CMI)	1	20	0	$25.88	$27.36	$30.81
	Available brands
	Dilaudid

Source	General Schedule
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
8541MMPNP	HYDROMORPHONE hydromorphone hydrochloride 2 mg tablet, 20 (PI, CMI)	1	20	0	$25.88	$27.36	$30.81
	Available brands
	Dilaudid