Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
13856GMP	MYCOPHENOLATE mycophenolate 180 mg enteric tablet, 120 (PI, CMI)	2	240	5	$202.17	$31.60	$31.60
	Available brands
	Mycophenolic Acid ARXa
	Myfortica

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

Note

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
13884RMP	MYCOPHENOLATE mycophenolate mofetil 250 mg capsule, 100 (PI, CMI)	6	600	5	$181.11	$31.60	$31.60
	Available brands
	APO-Mycophenolatea
	Mycophenolate Sandoza
	Pharmacor Mycophenolate 250a

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
13938NMP	MYCOPHENOLATE mycophenolate 360 mg enteric tablet, 120 (PI, CMI)	2	240	5	$395.83	$31.60	$31.60
	Available brands
	MYCOTEXa
	Mycophenolic Acid ARXa
	Myfortica

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
14000WMP	MYCOPHENOLATE mycophenolate mofetil 500 mg tablet, 50 (PI, CMI)	6	300	5	$180.87	$31.60	$31.60
	Available brands
	ARX-MYCOPHENOLATEa
	Ceptolatea
	MycoCepta
	Mycophenolate APOTEXa
	Mycophenolate GHa
	Mycophenolate Sandoza
	Pharmacor Mycophenolate 500a

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

Note

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
14037TMP	MYCOPHENOLATE mycophenolate mofetil 250 mg capsule, 50 (PI, CMI)	12	600	5	$181.11	$31.60	$31.60
	Available brands
	Ceptolatea

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
14071NMP	MYCOPHENOLATE mycophenolate mofetil 1 g/5 mL powder for oral liquid, 165 mL (PI, CMI)	2	2	5	$563.71	$31.60	$31.60
	Available brands
	CellCepta
	Pharmacor Mycophenolatea

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

Note

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
1836PMP	MYCOPHENOLATE mycophenolate mofetil 250 mg capsule, 50 (PI, CMI)	6	300	5	$95.67	$31.60	$31.60
	Available brands
	Ceptolatea

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

Note

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
1837QMP	MYCOPHENOLATE mycophenolate mofetil 250 mg capsule, 50 (PI, CMI)	12	600	5	$167.67	$31.60	$31.60
	Available brands
	Ceptolatea

Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

Note

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
1839TMP	MYCOPHENOLATE mycophenolate mofetil 250 mg capsule, 50 (PI, CMI)	12	600	5	$152.88	$31.60	$31.60
	Available brands
	Ceptolatea

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
2150EMP	MYCOPHENOLATE mycophenolate 180 mg enteric tablet, 120 (PI, CMI)	1	120	5	$105.70	$31.60	$31.60
	Available brands
	Mycophenolic Acid ARXa
	Myfortica

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
2193KMP	MYCOPHENOLATE mycophenolate 360 mg enteric tablet, 120 (PI, CMI)	1	120	5	$202.14	$31.60	$31.60
	Available brands
	MYCOTEXa
	Mycophenolic Acid ARXa
	Myfortica

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

Note

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
6208RMP	MYCOPHENOLATE mycophenolate mofetil 250 mg capsule, 100 (PI, CMI)	6	600	5	$167.67	$31.60	$31.60
	Available brands
	APO-Mycophenolatea
	Mycophenolate Sandoza
	Pharmacor Mycophenolate 250a

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
6209TMP	MYCOPHENOLATE mycophenolate mofetil 500 mg tablet, 50 (PI, CMI)	6	300	5	$167.55	$31.60	$31.60
	Available brands
	ARX-MYCOPHENOLATEa
	Ceptolatea
	MycoCepta
	Mycophenolate APOTEXa
	Mycophenolate GHa
	Mycophenolate Sandoza
	Pharmacor Mycophenolate 500a

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
6364YMP	MYCOPHENOLATE mycophenolate mofetil 1 g/5 mL powder for oral liquid, 165 mL (PI, CMI)	2	2	5	$520.41	$31.60	$31.60
	Available brands
	CellCepta
	Pharmacor Mycophenolatea

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

Note

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
6369FMP	MYCOPHENOLATE mycophenolate 180 mg enteric tablet, 120 (PI, CMI)	2	240	5	$187.11	$31.60	$31.60
	Available brands
	Mycophenolic Acid ARXa
	Myfortica

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

Note

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
6370GMP	MYCOPHENOLATE mycophenolate 360 mg enteric tablet, 120 (PI, CMI)	2	240	5	$365.51	$31.60	$31.60
	Available brands
	MYCOTEXa
	Mycophenolic Acid ARXa
	Myfortica

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

Note

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
8649FMP	MYCOPHENOLATE mycophenolate mofetil 250 mg capsule, 100 (PI, CMI)	3	300	5	$95.67	$31.60	$31.60
	Available brands
	APO-Mycophenolatea
	Mycophenolate Sandoza
	Pharmacor Mycophenolate 250a

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
8650GMP	MYCOPHENOLATE mycophenolate mofetil 500 mg tablet, 50 (PI, CMI)	3	150	5	$95.58	$31.60	$31.60
	Available brands
	ARX-MYCOPHENOLATEa
	Ceptolatea
	MycoCepta
	Mycophenolate APOTEXa
	Mycophenolate GHa
	Mycophenolate Sandoza
	Pharmacor Mycophenolate 500a

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
8651HMP	MYCOPHENOLATE mycophenolate mofetil 1 g/5 mL powder for oral liquid, 165 mL (PI, CMI)	1	1	5	$287.67	$31.60	$31.60
	Available brands
	CellCepta
	Pharmacor Mycophenolatea

Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
9500BMP	MYCOPHENOLATE mycophenolate mofetil 1 g/5 mL powder for oral liquid, 165 mL (PI, CMI)	2	2	5	$489.02	$31.60	$31.60
	Available brands
	CellCepta
	Pharmacor Mycophenolatea

Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

Note

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
9501CMP	MYCOPHENOLATE mycophenolate mofetil 250 mg capsule, 100 (PI, CMI)	6	600	5	$152.88	$31.60	$31.60
	Available brands
	APO-Mycophenolatea
	Mycophenolate Sandoza
	Pharmacor Mycophenolate 250a

Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
9502DMP	MYCOPHENOLATE mycophenolate mofetil 500 mg tablet, 50 (PI, CMI)	6	300	5	$152.76	$31.60	$31.60
	Available brands
	ARX-MYCOPHENOLATEa
	Ceptolatea
	MycoCepta
	Mycophenolate APOTEXa
	Mycophenolate GHa
	Mycophenolate Sandoza
	Pharmacor Mycophenolate 500a

Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

Note

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
9503EMP	MYCOPHENOLATE mycophenolate 180 mg enteric tablet, 120 (PI, CMI)	2	240	5	$171.58	$31.60	$31.60
	Available brands
	Mycophenolic Acid ARXa
	Myfortica

Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

Note

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
9504FMP	MYCOPHENOLATE mycophenolate 360 mg enteric tablet, 120 (PI, CMI)	2	240	5	$343.12	$31.60	$31.60
	Available brands
	MYCOTEXa
	Mycophenolic Acid ARXa
	Myfortica