Source	General Schedule
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTITHROMBOTIC AGENTS > ANTITHROMBOTIC AGENTS

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
10414DMPNP	APIXABAN apixaban 5 mg tablet, 28 (PI, CMI)	1	28	0	$49.27	$30.00	$30.00
	Available brands
	Eliquis

Source	General Schedule
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTITHROMBOTIC AGENTS > ANTITHROMBOTIC AGENTS

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
13464PMPNP	APIXABAN apixaban 2.5 mg tablet, 60 (PI, CMI)	2	120	5	$171.25	$30.00	$30.00
	Available brands
	Eliquis

Source	General Schedule
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTITHROMBOTIC AGENTS > ANTITHROMBOTIC AGENTS

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
13525WMPNP	APIXABAN apixaban 5 mg tablet, 60 (PI, CMI)	2	120	5	$171.25	$30.00	$30.00
	Available brands
	Eliquis

Source	General Schedule
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTITHROMBOTIC AGENTS > ANTITHROMBOTIC AGENTS

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
2735YMPNP	APIXABAN apixaban 5 mg tablet, 60 (PI, CMI)	1	60	5	$90.73	$30.00	$30.00
	Available brands
	Eliquis

Source	General Schedule
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTITHROMBOTIC AGENTS > ANTITHROMBOTIC AGENTS

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
2744KMPNP	APIXABAN apixaban 2.5 mg tablet, 60 (PI, CMI)	1	60	5	$90.73	$30.00	$30.00
	Available brands
	Eliquis

Source	General Schedule
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTITHROMBOTIC AGENTS > ANTITHROMBOTIC AGENTS

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
5054BMPNP	APIXABAN apixaban 2.5 mg tablet, 30 (PI, CMI)	1	30	0	$51.86	$30.00	$30.00
	Available brands
	Eliquis

Source	General Schedule
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTITHROMBOTIC AGENTS > ANTITHROMBOTIC AGENTS

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
5061JMPNP	APIXABAN apixaban 2.5 mg tablet, 60 (PI, CMI)	1	60	0	$90.73	$30.00	$30.00
	Available brands
	Eliquis

Source	General Schedule
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTITHROMBOTIC AGENTS > ANTITHROMBOTIC AGENTS

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
5500LMPNP	APIXABAN apixaban 2.5 mg tablet, 20 (PI, CMI)	1	20	0	$38.90	$30.00	$30.00
	Available brands
	Eliquis