Source	General Schedule
Body System	DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN

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
10791YMPNP	MOMETASONE mometasone furoate 0.1% ointment, 15 g (PI, CMI)	10	10	5	$51.38	$31.60	$31.60
	Available brands
	Momasonea
	Novasonea
	Zatamila
	Elocona * Additional charge for this brand is $35.30B	10	10	5	$86.68	$31.60	$66.90

Source	General Schedule
Body System	DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN

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
10792BMPNP	MOMETASONE mometasone furoate 0.1% cream, 15 g (PI, CMI)	10	10	5	$51.38	$31.60	$31.60
	Available brands
	Momasone Alcohol Freea
	Novasonea
	Elocon Alcohol Freea * Additional charge for this brand is $35.30B	10	10	5	$86.68	$31.60	$66.90

Source	General Schedule
Body System	DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN

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
10793CMPNP	MOMETASONE mometasone furoate 0.1% ointment, 15 g (PI, CMI)	8	8	5	$43.84	$31.60	$31.60
	Available brands
	Momasonea
	Novasonea
	Zatamila
	Elocona * Additional charge for this brand is $28.24B	8	8	5	$72.08	$31.60	$59.84

Source	General Schedule
Body System	DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN

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
10804PMPNP	MOMETASONE mometasone furoate 0.1% lotion, 30 mL (PI, CMI)	5	5	5	$39.93	$31.60	$31.60
	Available brands
	Novasonea
	Zatamila
	Elocona * Additional charge for this brand is $22.50B	5	5	5	$62.43	$31.60	$54.10

Source	General Schedule
Body System	DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN

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
10805QMPNP	MOMETASONE mometasone furoate 0.1% lotion, 30 mL (PI, CMI)	4	4	5	$34.72	$31.60	$31.60
	Available brands
	Novasonea
	Zatamila
	Elocona * Additional charge for this brand is $18.00B	4	4	5	$52.72	$31.60	$49.60

Source	General Schedule
Body System	DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN

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
10809XMPNP	MOMETASONE mometasone furoate 0.1% cream, 15 g (PI, CMI)	4	4	5	$28.84	$30.32	$31.60
	Available brands
	Momasone Alcohol Freea
	Novasonea
	Elocon Alcohol Freea * Additional charge for this brand is $14.12B	4	4	5	$42.96	$30.32	$45.72

Source	General Schedule
Body System	DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN

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
10812CMPNP	MOMETASONE mometasone furoate 0.1% ointment, 15 g (PI, CMI)	2	2	5	$21.32	$22.80	$26.25
	Available brands
	Momasonea
	Novasonea
	Zatamila
	Elocona * Additional charge for this brand is $7.06B	2	2	5	$28.38	$22.80	$33.31

Source	General Schedule
Body System	DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN

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
10814EMPNP	MOMETASONE mometasone furoate 0.1% ointment, 15 g (PI, CMI)	4	4	5	$28.84	$30.32	$31.60
	Available brands
	Momasonea
	Novasonea
	Zatamila
	Elocona * Additional charge for this brand is $14.12B	4	4	5	$42.96	$30.32	$45.72

Source	General Schedule
Body System	DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN

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
10815FMPNP	MOMETASONE mometasone furoate 0.1% cream, 15 g (PI, CMI)	6	6	5	$36.36	$31.60	$31.60
	Available brands
	Momasone Alcohol Freea
	Novasonea
	Elocon Alcohol Freea * Additional charge for this brand is $21.18B	6	6	5	$57.54	$31.60	$52.78

Source	General Schedule
Body System	DERMATOLOGICALS > CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS > CORTICOSTEROIDS, PLAIN

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
10818JMPNP	MOMETASONE mometasone furoate 0.1% cream, 15 g (PI, CMI)	8	8	5	$43.84	$31.60	$31.60
	Available brands
	Momasone Alcohol Freea
	Novasonea
	Elocon Alcohol Freea * Additional charge for this brand is $28.24B	8	8	5	$72.08	$31.60	$59.84