FOLLITROPIN ALFA

Source S100 IVF
Body System GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS
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
6433NMP FOLLITROPIN ALFA
follitropin alfa 900 units (65.52 microgram)/1.5 mL injection, 1.5 mL pen device (PI, CMI)
5 5 0 $1685.77 $31.60 $31.60
Available brands
Gonal-f Pena
space

FOLLITROPIN ALFA

Source General Schedule
Body System GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS
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
8715QMP FOLLITROPIN ALFA
follitropin alfa 900 units (65.52 microgram)/1.5 mL injection, 1.5 mL pen device (PI, CMI)
2 2 5 $747.43 $31.60 $31.60
Available brands
Gonal-f Pena
space


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