Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

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
14353KMPNPOP	PARAFFIN paraffin 1 g/g eye ointment, 3.5 g (PI, CMI)	4	4	5	$28.87	$30.32	$31.60
	Available brands
	Poly Visc

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

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
14493TMPNPOP	PARAFFIN paraffin 1 g/g eye ointment, 2 x 3.5 g (PI, CMI)	2	2	5	$28.23	$29.68	$31.60
	Available brands
	Poly Visc
	Refresh Night Time * Additional charge for this brand is $2.18B	2	2	5	$30.41	$29.68	$33.78

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

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
1750DMPNP	PARAFFIN paraffin 1 g/g eye ointment, 2 x 3.5 g (PI, CMI)	1	1	5	$20.84	$22.29	$25.74
	Available brands
	Poly Visc
	Refresh Night Time * Additional charge for this brand is $1.09B	1	1	5	$21.93	$22.29	$26.83

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

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
1754HMPNP	PARAFFIN paraffin 1 g/g eye ointment, 3.5 g (PI, CMI)	2	2	5	$21.17	$22.62	$26.07
	Available brands
	Poly Visc

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

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
5522POP	PARAFFIN paraffin 1 g/g eye ointment, 2 x 3.5 g (PI, CMI)	1	1	5	$20.84	$22.29	$25.74
	Available brands
	Poly Visc
	Refresh Night Time * Additional charge for this brand is $1.09B	1	1	5	$21.93	$22.29	$26.83

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

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
5523QOP	PARAFFIN paraffin 1 g/g eye ointment, 3.5 g (PI, CMI)	2	2	5	$21.17	$22.62	$26.07
	Available brands
	Poly Visc

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

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
9217DMP	PARAFFIN paraffin 1 g/g eye ointment, 3.5 g (PI, CMI)	2	2	11	$21.17	$22.62	$26.07
	Available brands
	Poly Visc SO Products that are in a Supply Only state will be available for dispensing, but not for prescribing. PBS Prescriptions written prior to the Supply Only period are able to be dispensed using either the Supply Only product where available, or an equivalent product as specified on the PBS schedule. Supply only

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OTHER OPHTHALMOLOGICALS

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
9218EMP	PARAFFIN paraffin 1 g/g eye ointment, 2 x 3.5 g (PI, CMI)	1	1	11	$20.84	$22.29	$25.74
	Available brands
	Poly Visc SO Products that are in a Supply Only state will be available for dispensing, but not for prescribing. PBS Prescriptions written prior to the Supply Only period are able to be dispensed using either the Supply Only product where available, or an equivalent product as specified on the PBS schedule. Supply only
	Refresh Night Time SO Products that are in a Supply Only state will be available for dispensing, but not for prescribing. PBS Prescriptions written prior to the Supply Only period are able to be dispensed using either the Supply Only product where available, or an equivalent product as specified on the PBS schedule. Supply only * Additional charge for this brand is $1.09B	1	1	11	$21.93	$22.29	$25.74