Source	General Schedule
Body System	NERVOUS SYSTEM > ANTI-PARKINSON DRUGS > DOPAMINERGIC AGENTS

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
14329EMPNP	PRAMIPEXOLE pramipexole dihydrochloride monohydrate 250 microgram tablet, 100 (PI, CMI)	2	200	5	$43.03	$31.60	$31.60
	Available brands
	APO-Pramipexolea
	Simipex 0.25a
	Simprala
	Sifrola * Additional charge for this brand is $7.54B	2	200	5	$50.57	$31.60	$39.14

Source	General Schedule
Body System	NERVOUS SYSTEM > ANTI-PARKINSON DRUGS > DOPAMINERGIC AGENTS

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
9152QMPNP	PRAMIPEXOLE pramipexole dihydrochloride monohydrate 250 microgram tablet, 100 (PI, CMI)	1	100	5	$28.24	$29.69	$31.60
	Available brands
	APO-Pramipexolea
	Simipex 0.25a
	Simprala
	Sifrola * Additional charge for this brand is $3.77B	1	100	5	$32.01	$29.69	$35.37

Source	General Schedule
Body System	NERVOUS SYSTEM > ANTI-PARKINSON DRUGS > DOPAMINERGIC AGENTS

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
9394KMPNP	PRAMIPEXOLE pramipexole dihydrochloride monohydrate 250 microgram tablet, 100 (PI, CMI)	1	100	2	$28.24	$29.69	$31.60
	Available brands
	APO-Pramipexolea
	Simipex 0.25a
	Simprala
	Sifrola * Additional charge for this brand is $3.77B	1	100	2	$32.01	$29.69	$35.37