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

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
1915TMPNP	MOMETASONE mometasone furoate 0.1% ointment, 15 g (PI, CMI)	1	1	0	$17.22	$18.67	$22.12
	Available brands
	Momasonea
	Novasonea
	Zatamila
	Elocona * Additional charge for this brand is $3.53B	1	1	0	$20.75	$18.67	$25.65

Source	Repatriation Pharmaceutical Benefits
Body System	DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN

Note

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
4342MMP	MOMETASONER mometasone furoate 0.1% cream, 50 g (PI, CMI)
	Available brands
	Elocon Alcohol Free	1	1	0	$36.99	$7.70	$7.70

Source	Repatriation Pharmaceutical Benefits
Body System	DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN

Note

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
4343NMP	MOMETASONER mometasone furoate 0.1% ointment, 50 g (PI, CMI)
	Available brands
	Elocon	1	1	0	$36.99	$7.70	$7.70

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
8043HMPNP	MOMETASONE mometasone furoate 0.1% lotion, 30 mL (PI, CMI)	1	1	0	$18.69	$20.14	$23.59
	Available brands
	Novasonea
	Zatamila
	Elocona * Additional charge for this brand is $4.50B	1	1	0	$23.19	$20.14	$28.09