Source	S100 HSD Public
Body System	VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS

Note

Authority Required

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
11231DMP	DEFERASIROX deferasirox 500 mg dispersible tablet, 28 (PI, CMI)	6	168	2	$2374.68	$31.60	$31.60
	Available brands
	Deferasirox Junoa
	Pharmacor Deferasiroxa

Source	S100 HSD Private
Body System	VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS

Note

Authority Required

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
11232EMP	DEFERASIROX deferasirox 500 mg dispersible tablet, 28 (PI, CMI)	6	168	2	$2423.07	$31.60	$31.60
	Available brands
	Deferasirox Junoa
	Pharmacor Deferasiroxa

Source	S100 HSD Public
Body System	VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS

Note

Authority Required

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
11234GMP	DEFERASIROX deferasirox 500 mg dispersible tablet, 28 (PI, CMI)	6	168	5	$2374.68	$31.60	$31.60
	Available brands
	Deferasirox Junoa
	Pharmacor Deferasiroxa

Source	S100 HSD Public
Body System	VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS

Note

Authority Required

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
11235HMP	DEFERASIROX deferasirox 125 mg dispersible tablet, 28 (PI, CMI)	6	168	2	$593.70	$31.60	$31.60
	Available brands
	Deferasirox Junoa
	Pharmacor Deferasiroxa

Source	S100 HSD Private
Body System	VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS

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
11236JMP	DEFERASIROX deferasirox 125 mg dispersible tablet, 28 (PI, CMI)	6	168	2	$625.83	$31.60	$31.60
	Available brands
	Deferasirox Junoa
	Pharmacor Deferasiroxa

Source	S100 HSD Private
Body System	VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS

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
11238LMP	DEFERASIROX deferasirox 250 mg dispersible tablet, 28 (PI, CMI)	6	168	2	$859.83	$31.60	$31.60
	Available brands
	Deferasirox Junoa
	Pharmacor Deferasiroxa

Source	S100 HSD Public
Body System	VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS

Note

Authority Required

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
11239MMP	DEFERASIROX deferasirox 250 mg dispersible tablet, 28 (PI, CMI)	6	168	2	$818.70	$31.60	$31.60
	Available brands
	Deferasirox Junoa
	Pharmacor Deferasiroxa

Source	S100 HSD Public
Body System	VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS

Note

Authority Required

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
11240NMP	DEFERASIROX deferasirox 250 mg dispersible tablet, 28 (PI, CMI)	6	168	5	$818.70	$31.60	$31.60
	Available brands
	Deferasirox Junoa
	Pharmacor Deferasiroxa

Source	S100 HSD Private
Body System	VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS

Note

Authority Required

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
11241PMP	DEFERASIROX deferasirox 125 mg dispersible tablet, 28 (PI, CMI)	6	168	2	$625.83	$31.60	$31.60
	Available brands
	Deferasirox Junoa
	Pharmacor Deferasiroxa

Source	S100 HSD Private
Body System	VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS

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
11243RMP	DEFERASIROX deferasirox 500 mg dispersible tablet, 28 (PI, CMI)	6	168	2	$2423.07	$31.60	$31.60
	Available brands
	Deferasirox Junoa
	Pharmacor Deferasiroxa

Source	S100 HSD Private
Body System	VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS

Note

Authority Required

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
11244TMP	DEFERASIROX deferasirox 250 mg dispersible tablet, 28 (PI, CMI)	6	168	2	$859.83	$31.60	$31.60
	Available brands
	Deferasirox Junoa
	Pharmacor Deferasiroxa

Source	S100 HSD Public
Body System	VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS

Note

Authority Required

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
11247YMP	DEFERASIROX deferasirox 125 mg dispersible tablet, 28 (PI, CMI)	6	168	5	$593.70	$31.60	$31.60
	Available brands
	Deferasirox Junoa
	Pharmacor Deferasiroxa

Source	S100 HSD Public
Body System	VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS

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
5654NMP	DEFERASIROX deferasirox 125 mg dispersible tablet, 28 (PI, CMI)	6	168	2	$593.70	$31.60	$31.60
	Available brands
	Deferasirox Junoa
	Pharmacor Deferasiroxa

Source	S100 HSD Public
Body System	VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS

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
5655PMP	DEFERASIROX deferasirox 250 mg dispersible tablet, 28 (PI, CMI)	6	168	2	$818.70	$31.60	$31.60
	Available brands
	Deferasirox Junoa
	Pharmacor Deferasiroxa

Source	S100 HSD Public
Body System	VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS

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
5656QMP	DEFERASIROX deferasirox 500 mg dispersible tablet, 28 (PI, CMI)	6	168	2	$2374.68	$31.60	$31.60
	Available brands
	Deferasirox Junoa
	Pharmacor Deferasiroxa

Source	S100 HSD Private
Body System	VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS

Note

Authority Required

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
6499CMP	DEFERASIROX deferasirox 125 mg dispersible tablet, 28 (PI, CMI)	6	168	5	$625.83	$31.60	$31.60
	Available brands
	Deferasirox Junoa
	Pharmacor Deferasiroxa

Source	S100 HSD Private
Body System	VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS

Note

Authority Required

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
6500DMP	DEFERASIROX deferasirox 250 mg dispersible tablet, 28 (PI, CMI)	6	168	5	$859.83	$31.60	$31.60
	Available brands
	Deferasirox Junoa
	Pharmacor Deferasiroxa

Source	S100 HSD Private
Body System	VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS

Note

Authority Required

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
9600GMP	DEFERASIROX deferasirox 500 mg dispersible tablet, 28 (PI, CMI)	6	168	5	$2423.07	$31.60	$31.60
	Available brands
	Deferasirox Junoa
	Pharmacor Deferasiroxa