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
8542NMPNP	HYDROMORPHONE hydromorphone hydrochloride 4 mg tablet, 20 (PI, CMI)	1	20	0	$28.15	$29.63	$31.60
	Available brands
	Dilaudid