ECULIZUMAB

Source S100 HSD Private
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
10182XMP ECULIZUMAB
eculizumab 300 mg/30 mL injection, 30 mL vial (PI, CMI)
1 1 0 $5688.45 $42.50 $42.50
Available brands
Soliris
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ECULIZUMAB

Source S100 HSD Public
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
10183YMP ECULIZUMAB
eculizumab 300 mg/30 mL injection, 30 mL vial (PI, CMI)
1 1 5 $5640.63 $42.50 $42.50
Available brands
Soliris
space

ECULIZUMAB

Source S100 HSD Public
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
10190HMP ECULIZUMAB
eculizumab 300 mg/30 mL injection, 30 mL vial (PI, CMI)
1 1 4 $5640.63 $42.50 $42.50
Available brands
Soliris
space

ECULIZUMAB

Source S100 HSD Public
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
10191JMP ECULIZUMAB
eculizumab 300 mg/30 mL injection, 30 mL vial (PI, CMI)
1 1 0 $5640.63 $42.50 $42.50
Available brands
Soliris
space

ECULIZUMAB

Source S100 HSD Private
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
10192KMP ECULIZUMAB
eculizumab 300 mg/30 mL injection, 30 mL vial (PI, CMI)
1 1 4 $5688.45 $42.50 $42.50
Available brands
Soliris
space

ECULIZUMAB

Source S100 HSD Private
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
10194MMP ECULIZUMAB
eculizumab 300 mg/30 mL injection, 30 mL vial (PI, CMI)
1 1 5 $5688.45 $42.50 $42.50
Available brands
Soliris
space

ECULIZUMAB

Source S100 HSD Private
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
10521RMP ECULIZUMAB
eculizumab 300 mg/30 mL injection, 30 mL vial (PI, CMI)
1 1 6 $5688.45 $42.50 $42.50
Available brands
Soliris
space

ECULIZUMAB

Source S100 HSD Public
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
10525YMP ECULIZUMAB
eculizumab 300 mg/30 mL injection, 30 mL vial (PI, CMI)
1 1 6 $5640.63 $42.50 $42.50
Available brands
Soliris
space

ECULIZUMAB

Source S100 HSD Public
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12840TMP ECULIZUMAB
eculizumab 300 mg/30 mL injection, 30 mL vial (PI, CMI)
8 8 0 $45125.04 $42.50 $42.50
Available brands
Soliris
space

ECULIZUMAB

Source S100 HSD Private
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12864CMP ECULIZUMAB
eculizumab 300 mg/30 mL injection, 30 mL vial (PI, CMI)
1 1 0 $5688.45 $42.50 $42.50
Available brands
Soliris
space

ECULIZUMAB

Source S100 HSD Public
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12877RMP ECULIZUMAB
eculizumab 300 mg/30 mL injection, 30 mL vial (PI, CMI)
6 6 5 $33843.78 $42.50 $42.50
Available brands
Soliris
space

ECULIZUMAB

Source S100 HSD Private
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12896RMP ECULIZUMAB
eculizumab 300 mg/30 mL injection, 30 mL vial (PI, CMI)
8 8 0 $45172.86 $42.50 $42.50
Available brands
Soliris
space

ECULIZUMAB

Source S100 HSD Private
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12899XMP ECULIZUMAB
eculizumab 300 mg/30 mL injection, 30 mL vial (PI, CMI)
6 6 5 $33891.62 $42.50 $42.50
Available brands
Soliris
space

ECULIZUMAB

Source S100 HSD Public
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12900YMP ECULIZUMAB
eculizumab 300 mg/30 mL injection, 30 mL vial (PI, CMI)
1 1 0 $5640.63 $42.50 $42.50
Available brands
Soliris
space


  • Legend
  • MPMedical Practitioner