Source	General Schedule
Body System	GENITO URINARY SYSTEM AND SEX HORMONES > OTHER GYNECOLOGICALS > CONTRACEPTIVES FOR TOPICAL USE

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
11909TMPNP	LEVONORGESTREL levonorgestrel 19.5 mg intrauterine drug delivery system, 1 system (PI, CMI)	1	1	0	$171.79	$31.60	$31.60
	Available brands
	Kyleena

Source	General Schedule
Body System	GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > HORMONAL CONTRACEPTIVES FOR SYSTEMIC USE

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
2913HMPMWNP	LEVONORGESTREL levonorgestrel 30 microgram tablet, 112 tablets [4 x 28] (PI, CMI)	1	4	2	$21.16	$22.61	$26.06
	Available brands
	Microlut 28

Source	General Schedule
Body System	GENITO URINARY SYSTEM AND SEX HORMONES > OTHER GYNECOLOGICALS > CONTRACEPTIVES FOR TOPICAL USE

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
8633JMPNP	LEVONORGESTREL levonorgestrel 52 mg intrauterine drug delivery system, 1 system (PI, CMI)	1	1	0	$168.86	$31.60	$31.60
	Available brands
	Mirena