PERTUZUMAB
|
|
|
|
| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 10267JMP | PERTUZUMAB Injection (PI, CMI)
|
840 mg | 0 | $5,928.73 | $25.00 | $25.00 |
TRASTUZUMAB EMTANSINE
|
|
|
|
| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
|---|---|---|---|---|---|---|---|---|---|
| 10281DMP | TRASTUZUMAB EMTANSINE Injection (PI, CMI)
|
450 mg | 8 | $7,417.40 | $25.00 | $25.00 |
TRASTUZUMAB EMTANSINE
|
|
|
|
| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
|---|---|---|---|---|---|---|---|---|---|
| 10282EMP | TRASTUZUMAB EMTANSINE Injection (PI, CMI)
|
450 mg | 8 | $7,271.22 | $25.00 | $25.00 |
PERTUZUMAB
|
|
|
|
| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 10308MMP | PERTUZUMAB Injection (PI, CMI)
|
420 mg | 3 | $3,096.51 | $25.00 | $25.00 |
PERTUZUMAB
|
|
|
|
| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 10333WMP | PERTUZUMAB Injection (PI, CMI)
|
420 mg | 3 | $3,009.98 | $25.00 | $25.00 |
PERTUZUMAB
|
|
|
|
| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 10334XMP | PERTUZUMAB Injection (PI, CMI)
|
840 mg | 0 | $6,056.12 | $25.00 | $25.00 |
TRASTUZUMAB
|
|
|
|
| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 10383LMP | TRASTUZUMAB Injection (PI, CMI)
|
750 mg | 3 | $686.45 | $25.00 | $25.00 |
TRASTUZUMAB
|
|
|
|
| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 10391XMP | TRASTUZUMAB Injection (PI, CMI)
|
1000 mg | 0 | $831.87 | $25.00 | $25.00 |
TRASTUZUMAB
|
|
|
|
| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 10401KMP | TRASTUZUMAB Injection (PI, CMI)
|
750 mg | 3 | $663.48 | $25.00 | $25.00 |
TRASTUZUMAB
|
|
|
|
| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 10402LMP | TRASTUZUMAB Injection (PI, CMI)
|
1000 mg | 0 | $857.19 | $25.00 | $25.00 |
TRASTUZUMAB
| Source | General Schedule |
| Body System | ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES |
|
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| 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 |
|---|---|---|---|---|---|---|---|
| 10798HMP | TRASTUZUMAB trastuzumab 600 mg/5 mL injection, 5 mL vial (PI, CMI) |
1 | 1 | 0 | $1,609.37 | $25.00 | $25.00 |
| Available brands | |||||||
| Herceptin SC |
TRASTUZUMAB
| Source | General Schedule |
| Body System | ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES |
|
|
|
|
| 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 |
|---|---|---|---|---|---|---|---|
| 10803NMP | TRASTUZUMAB trastuzumab 600 mg/5 mL injection, 5 mL vial (PI, CMI) |
1 | 1 | 3 | $1,609.37 | $25.00 | $25.00 |
| Available brands | |||||||
| Herceptin SC |
TRASTUZUMAB
| Source | Section 100 (CT) |
| Body System | ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES |
|
|
|
|
| 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 |
|---|---|---|---|---|---|---|---|
| 10811BMP | TRASTUZUMAB trastuzumab 600 mg/5 mL injection, 5 mL vial (PI, CMI) |
1 | 1 | 0 | $1,470.22 | $25.00 | $25.00 |
| Available brands | |||||||
| Herceptin SC |
TRASTUZUMAB
| Source | Section 100 (CT) |
| Body System | ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES |
|
|
|
|
| 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 |
|---|---|---|---|---|---|---|---|
| 10817HMP | TRASTUZUMAB trastuzumab 600 mg/5 mL injection, 5 mL vial (PI, CMI) |
1 | 1 | 3 | $1,470.22 | $25.00 | $25.00 |
| Available brands | |||||||
| Herceptin SC |
LAPATINIB
| Source | General Schedule |
| Body System | ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS |
|
|
|
|
| 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 |
|---|---|---|---|---|---|---|---|
| 11251EMP | LAPATINIB lapatinib 250 mg tablet, 70 (PI, CMI) |
2 | 140 | 2 | $2,210.82 | $25.00 | $25.00 |
| Available brands | |||||||
| Tykerb |
TRASTUZUMAB DERUXTECAN
|
|
|
|
| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 13713RMP | TRASTUZUMAB DERUXTECAN Injection (PI, CMI)
|
675 mg | 8 | $17,832.62 | $25.00 | $25.00 |
TRASTUZUMAB DERUXTECAN
|
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|
|
| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 13718BMP | TRASTUZUMAB DERUXTECAN Injection (PI, CMI)
|
675 mg | 8 | $17,542.65 | $25.00 | $25.00 |
LAPATINIB
| Source | General Schedule |
| Body System | ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS |
|
|
|
|
| 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 |
|---|---|---|---|---|---|---|---|
| 9148LMP | LAPATINIB lapatinib 250 mg tablet, 70 (PI, CMI) |
2 | 140 | 2 | $2,210.82 | $25.00 | $25.00 |
| Available brands | |||||||
| Tykerb |
- Legend
- MPMedical Practitioner




