FOLLITROPIN ALFA
Source | S100 IVF |
Body System | GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS |
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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 |
---|---|---|---|---|---|---|---|
10861PMP | FOLLITROPIN ALFA follitropin alfa 75 units (5.5 microgram)/0.125 mL injection, 5 x 0.125 mL pen devices (PI, CMI) |
3 | 15 | 0 | $433.47 | $41.30 | $41.30 |
Available brands | |||||||
Bemfola |
FOLLITROPIN ALFA
Source | General Schedule |
Body System | GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS |
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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 |
---|---|---|---|---|---|---|---|
10865WMP | FOLLITROPIN ALFA follitropin alfa 75 units (5.5 microgram)/0.125 mL injection, 5 x 0.125 mL pen devices (PI, CMI) |
3 | 15 | 1 | $469.17 | $41.30 | $41.30 |
Available brands | |||||||
Bemfola |
FOLLITROPIN ALFA
Source | S100 IVF |
Body System | GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS |
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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 |
---|---|---|---|---|---|---|---|
10866XMP | FOLLITROPIN ALFA follitropin alfa 300 units (22 microgram)/0.5 mL injection, 5 x 0.5 mL pen devices (PI, CMI) |
3 | 15 | 0 | $1685.13 | $41.30 | $41.30 |
Available brands | |||||||
Bemfola |
FOLLITROPIN ALFA
Source | S100 IVF |
Body System | GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS |
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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 |
---|---|---|---|---|---|---|---|
10867YMP | FOLLITROPIN ALFA follitropin alfa 450 units (33 microgram)/0.75 mL injection, 5 x 0.75 mL pen devices (PI, CMI) |
3 | 15 | 0 | $2503.83 | $41.30 | $41.30 |
Available brands | |||||||
Bemfola |
FOLLITROPIN ALFA
Source | S100 IVF |
Body System | GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS |
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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 |
---|---|---|---|---|---|---|---|
10872FMP | FOLLITROPIN ALFA follitropin alfa 225 units (16.5 microgram)/0.375 mL injection, 5 x 0.375 mL pen devices (PI, CMI) |
3 | 15 | 0 | $1275.78 | $41.30 | $41.30 |
Available brands | |||||||
Bemfola |
FOLLITROPIN ALFA
Source | S100 IVF |
Body System | GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS |
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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 |
---|---|---|---|---|---|---|---|
10873GMP | FOLLITROPIN ALFA follitropin alfa 150 units (11 microgram)/0.25 mL injection, 5 x 0.25 mL pen devices (PI, CMI) |
3 | 15 | 0 | $859.20 | $41.30 | $41.30 |
Available brands | |||||||
Bemfola |
FOLLITROPIN ALFA
Source | General Schedule |
Body System | GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS |
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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 |
---|---|---|---|---|---|---|---|
10876KMP | FOLLITROPIN ALFA follitropin alfa 225 units (16.5 microgram)/0.375 mL injection, 5 x 0.375 mL pen devices (PI, CMI) |
3 | 15 | 1 | $1353.33 | $41.30 | $41.30 |
Available brands | |||||||
Bemfola |
FOLLITROPIN ALFA
Source | General Schedule |
Body System | GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS |
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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 |
---|---|---|---|---|---|---|---|
10877LMP | FOLLITROPIN ALFA follitropin alfa 150 units (11 microgram)/0.25 mL injection, 5 x 0.25 mL pen devices (PI, CMI) |
3 | 15 | 1 | $923.52 | $41.30 | $41.30 |
Available brands | |||||||
Bemfola |
FOLLITROPIN ALFA
Source | S100 IVF |
Body System | GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS |
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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 |
---|---|---|---|---|---|---|---|
6431LMP | FOLLITROPIN ALFA follitropin alfa 300 units (21.84 microgram)/0.5 mL injection, 0.5 mL pen device (PI, CMI) |
2 | 2 | 0 | $234.80 | $41.30 | $41.30 |
Available brands | |||||||
Gonal-f Pen |
FOLLITROPIN ALFA
Source | S100 IVF |
Body System | GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS |
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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 |
---|---|---|---|---|---|---|---|
6432MMP | FOLLITROPIN ALFA follitropin alfa 450 units (32.76 microgram)/0.75 mL injection, 0.75 mL pen device (PI, CMI) |
2 | 2 | 0 | $348.32 | $41.30 | $41.30 |
Available brands | |||||||
Gonal-f Pen |
FOLLITROPIN ALFA
Source | S100 IVF |
Body System | GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS |
|
|
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 |
---|---|---|---|---|---|---|---|
6433NMP | FOLLITROPIN ALFA follitropin alfa 900 units (65.52 microgram)/1.5 mL injection, 1.5 mL pen device (PI, CMI) |
5 | 5 | 0 | $1685.14 | $41.30 | $41.30 |
Available brands | |||||||
Gonal-f Pen |
FOLLITROPIN ALFA
Source | General Schedule |
Body System | GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS |
|
|
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 |
---|---|---|---|---|---|---|---|
8713NMP | FOLLITROPIN ALFA follitropin alfa 300 units (21.84 microgram)/0.5 mL injection, 0.5 mL pen device (PI, CMI) |
3 | 3 | 5 | $376.74 | $41.30 | $41.30 |
Available brands | |||||||
Gonal-f Pen |
FOLLITROPIN ALFA
Source | General Schedule |
Body System | GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS |
|
|
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 |
---|---|---|---|---|---|---|---|
8714PMP | FOLLITROPIN ALFA follitropin alfa 450 units (32.76 microgram)/0.75 mL injection, 0.75 mL pen device (PI, CMI) |
3 | 3 | 5 | $561.57 | $41.30 | $41.30 |
Available brands | |||||||
Gonal-f Pen |
FOLLITROPIN ALFA
Source | General Schedule |
Body System | GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS |
|
|
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 |
---|---|---|---|---|---|---|---|
8715QMP | FOLLITROPIN ALFA follitropin alfa 900 units (65.52 microgram)/1.5 mL injection, 1.5 mL pen device (PI, CMI) |
2 | 2 | 5 | $746.46 | $41.30 | $41.30 |
Available brands | |||||||
Gonal-f Pen |
- Legend
- MPMedical Practitioner