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
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
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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
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
space

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
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
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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
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
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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
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
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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
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
space

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
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
space

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
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
space

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
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
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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
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
space

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
space

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
space

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
space

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
space


  • Legend
  • MPMedical Practitioner