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 unit doses (PI, CMI)	3	3	5	$25.82	$27.13	$30.00
	Available brands
	Optifresh Plusa
	Celluvisca * Additional charge for this brand is $4.83B	3	3	5	$30.65	$27.13	$34.83

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 unit doses (PI, CMI)	3	3	5	$25.82	$27.13	$30.00
	Available brands
	Optifresh Tearsa
	Cellufresha * Additional charge for this brand is $4.83B	3	3	5	$30.65	$27.13	$34.83

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	$15.29	$16.60	$19.89
	Available brands
	Refresh Tears Plus