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
5519LOP	HYPROMELLOSE + CARBOMER-980 hypromellose 0.3% + carbomer-980 0.2% eye gel, 10 g (PI, CMI)	1	1	5	$17.37	$18.82	$22.27
	Available brands
	HPMC PAAa
	Genteal gela * Additional charge for this brand is $4.65B	1	1	5	$22.02	$18.82	$26.92

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
8564RMPNP	HYPROMELLOSE + CARBOMER-980 hypromellose 0.3% + carbomer-980 0.2% eye gel, 10 g (PI, CMI)	1	1	5	$17.37	$18.82	$22.27
	Available brands
	HPMC PAAa
	Genteal gela * Additional charge for this brand is $4.65B	1	1	5	$22.02	$18.82	$26.92