Source	S100 IVF
Body System	GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS

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
11414RMP	FOLLITROPIN DELTA follitropin delta 72 microgram/2.16 mL injection, 2.16 mL pen device (PI, CMI)	4	4	0	$2065.01	$31.60	$31.60
	Available brands
	Rekovelle

Source	S100 IVF
Body System	GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS

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
11430NMP	FOLLITROPIN DELTA follitropin delta 12 microgram/0.36 mL injection, 0.36 mL pen device (PI, CMI)	5	5	0	$445.32	$31.60	$31.60
	Available brands
	Rekovelle

Source	S100 IVF
Body System	GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS

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
11431PMP	FOLLITROPIN DELTA follitropin delta 36 microgram/1.08 mL injection, 1.08 mL pen device (PI, CMI)	5	5	0	$1308.72	$31.60	$31.60
	Available brands
	Rekovelle