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
11667CMP	FOLLITROPIN ALFA + LUTROPIN ALFA follitropin alfa 900 units (65.52 microgram)/1.44 mL + lutropin alfa 450 units/1.44 mL injection, 1.44 mL pen device (PI, CMI)	2	2	0	$1823.49	$31.60	$31.60
	Available brands
	Pergoveris