Source	S100 HSD Public
Body System	MUSCULO-SKELETAL SYSTEM > MUSCLE RELAXANTS > MUSCLE RELAXANTS, CENTRALLY ACTING AGENTS

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
11195FMP	BACLOFEN baclofen 40 mg/20 mL intrathecal injection, 20 mL ampoule (PI, CMI)	2	2	0	$611.38	$31.60	$31.60
	Available brands
	Sintetica Baclofen Intrathecal