Source	General Schedule
Body System	MUSCULO-SKELETAL SYSTEM > MUSCLE RELAXANTS > MUSCLE RELAXANTS, CENTRALLY ACTING AGENTS

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
13359DMPNP	BACLOFEN baclofen 25 mg tablet, 100 (PI, CMI)	2	200	5	$57.09	$31.60	$31.60
	Available brands
	APO-Baclofena
	Clofen 25a
	Lioresal 25a
	Stelax 25a

Source	General Schedule
Body System	MUSCULO-SKELETAL SYSTEM > MUSCLE RELAXANTS > MUSCLE RELAXANTS, CENTRALLY ACTING AGENTS

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
2730QMPNP	BACLOFEN baclofen 25 mg tablet, 100 (PI, CMI)	1	100	5	$35.27	$31.60	$31.60
	Available brands
	APO-Baclofena
	Clofen 25a
	Lioresal 25a
	Stelax 25a