Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > BETA-LACTAM ANTIBACTERIALS, PENICILLINS

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
10790XMP	DICLOXACILLIN dicloxacillin 500 mg capsule, 24 (PI, CMI)	2	48	1	$29.67	$31.12	$31.60
	Available brands
	DICLOXACILLIN VIATRIS 500a
	Distaph 500a * Additional charge for this brand is $3.90B	2	48	1	$33.57	$31.12	$35.50

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > BETA-LACTAM ANTIBACTERIALS, PENICILLINS

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
5096FDP	DICLOXACILLIN dicloxacillin 250 mg capsule, 24 (PI, CMI)	1	24	0	$18.17	$19.62	$23.07
	Available brands
	DICLOXACILLIN VIATRIS 250a
	Dicloxacillin Mylan 250a
	Distaph 250a * Additional charge for this brand is $1.86B	1	24	0	$20.03	$19.62	$24.93

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > BETA-LACTAM ANTIBACTERIALS, PENICILLINS

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
5097GDP	DICLOXACILLIN dicloxacillin 500 mg capsule, 24 (PI, CMI)	1	24	0	$21.56	$23.01	$26.46
	Available brands
	DICLOXACILLIN VIATRIS 500a
	Distaph 500a * Additional charge for this brand is $1.95B	1	24	0	$23.51	$23.01	$28.41

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > BETA-LACTAM ANTIBACTERIALS, PENICILLINS

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
8121KMPMWNP	DICLOXACILLIN dicloxacillin 250 mg capsule, 24 (PI, CMI)	1	24	0	$18.17	$19.62	$23.07
	Available brands
	DICLOXACILLIN VIATRIS 250a
	Dicloxacillin Mylan 250a
	Distaph 250a * Additional charge for this brand is $1.86B	1	24	0	$20.03	$19.62	$24.93

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIBACTERIALS FOR SYSTEMIC USE > BETA-LACTAM ANTIBACTERIALS, PENICILLINS

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
8122LMPMWNP	DICLOXACILLIN dicloxacillin 500 mg capsule, 24 (PI, CMI)	1	24	0	$21.56	$23.01	$26.46
	Available brands
	DICLOXACILLIN VIATRIS 500a
	Distaph 500a * Additional charge for this brand is $1.95B	1	24	0	$23.51	$23.01	$28.41