AFLIBERCEPT

Source General Schedule
Body System SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS
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
10505XMP AFLIBERCEPT
aflibercept 4 mg/0.1 mL injection, 0.1 mL vial (PI, CMI)
1 1 5 $932.76 $30.00 $30.00
Available brands
Eyleaa
space

AFLIBERCEPT

Source General Schedule
Body System SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS
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
11991DMP AFLIBERCEPT
aflibercept 4 mg/0.1 mL injection, 0.1 mL vial (PI, CMI)
1 1 2 $932.76 $30.00 $30.00
Available brands
Eyleaa
space

AFLIBERCEPT

Source General Schedule
Body System SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS
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
12131LMP AFLIBERCEPT
aflibercept 4 mg/0.1 mL injection, 0.1 mL vial (PI, CMI)
1 1 2 $932.76 $30.00 $30.00
Available brands
Eyleaa
space

AFLIBERCEPT

Source General Schedule
Body System SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS
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
13138LMP AFLIBERCEPT
aflibercept 4 mg/0.1 mL injection, 0.1 mL vial (PI, CMI)
1 1 2 $932.76 $30.00 $30.00
Available brands
Eyleaa
space

AFLIBERCEPT

Source General Schedule
Body System SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS
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
13146XMP AFLIBERCEPT
aflibercept 4 mg/0.1 mL injection, 0.1 mL vial (PI, CMI)
1 1 2 $932.76 $30.00 $30.00
Available brands
Eyleaa
space

AFLIBERCEPT

Source General Schedule
Body System SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS
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
13151EMP AFLIBERCEPT
aflibercept 4 mg/0.1 mL injection, 0.1 mL vial (PI, CMI)
1 1 2 $932.76 $30.00 $30.00
Available brands
Eyleaa
space

AFLIBERCEPT

Source General Schedule
Body System SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS
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
13164WMP AFLIBERCEPT
aflibercept 4 mg/0.1 mL injection, 0.1 mL vial (PI, CMI)
1 1 5 $932.76 $30.00 $30.00
Available brands
Eyleaa
space

AFLIBERCEPT

Source General Schedule
Body System SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS
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
2168DMP AFLIBERCEPT
aflibercept 4 mg/0.1 mL injection, 0.1 mL vial (PI, CMI)
1 1 2 $932.76 $30.00 $30.00
Available brands
Eyleaa
space


  • Legend
  • aBrand equivalent a
  • MPMedical Practitioner