Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSTIMULANTS > IMMUNOSTIMULANTS

Note

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
11037XMPNP	PEGINTERFERON ALFA-2A peginterferon alfa-2a 180 microgram/0.5 mL injection, 4 x 0.5 mL syringes (PI, CMI)	1	4	5	$627.87	$25.00	$25.00
	Available brands
	Pegasysa

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSTIMULANTS > IMMUNOSTIMULANTS

Note

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
11416WMPNP	PEGINTERFERON ALFA-2A peginterferon alfa-2a 135 microgram/0.5 mL injection, 4 x 0.5 mL syringes (PI, CMI)	1	4	5	$543.37	$25.00	$25.00
	Available brands
	Pegasysa

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSTIMULANTS > IMMUNOSTIMULANTS

Note

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
14992CMPNP	PEGINTERFERON ALFA-2A peginterferon alfa-2a 180 microgram/0.5 mL injection, 4 x 0.5 mL syringes (PI, CMI)	1	4	5	$1,359.72	$25.00	$25.00
	Available brands
	Pegasys (Ireland)a

Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSTIMULANTS > IMMUNOSTIMULANTS

Caution

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
14993DMPNP	PEGINTERFERON ALFA-2A peginterferon alfa-2a 180 microgram/0.5 mL injection, 4 x 0.5 mL syringes (PI, CMI)	2	8	5	$2,464.92	$25.00	$25.00
	Available brands
	Pegasys (Ireland)a

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSTIMULANTS > IMMUNOSTIMULANTS

Caution

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
15015GMPNP	PEGINTERFERON ALFA-2A peginterferon alfa-2a 135 microgram/0.5 mL injection, 4 x 0.5 mL syringes (PI, CMI)	2	8	5	$2,408.02	$25.00	$25.00
	Available brands
	Pegasys (Ireland)a

Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSTIMULANTS > IMMUNOSTIMULANTS

Caution

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
15025TMPNP	PEGINTERFERON ALFA-2A peginterferon alfa-2a 135 microgram/0.5 mL injection, 4 x 0.5 mL syringes (PI, CMI)	2	8	5	$2,359.14	$25.00	$25.00
	Available brands
	Pegasys (Ireland)a

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSTIMULANTS > IMMUNOSTIMULANTS

Caution

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
15036JMPNP	PEGINTERFERON ALFA-2A peginterferon alfa-2a 180 microgram/0.5 mL injection, 4 x 0.5 mL syringes (PI, CMI)	2	8	5	$2,513.80	$25.00	$25.00
	Available brands
	Pegasys (Ireland)a

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSTIMULANTS > IMMUNOSTIMULANTS

Note

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
15045WMPNP	PEGINTERFERON ALFA-2A peginterferon alfa-2a 135 microgram/0.5 mL injection, 4 x 0.5 mL syringes (PI, CMI)	1	4	5	$1,304.19	$25.00	$25.00
	Available brands
	Pegasys (Ireland)a

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSTIMULANTS > IMMUNOSTIMULANTS

Caution

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
6439XMPNP	PEGINTERFERON ALFA-2A peginterferon alfa-2a 135 microgram/0.5 mL injection, 4 x 0.5 mL syringes (PI, CMI)	2	8	5	$993.78	$25.00	$25.00
	Available brands
	Pegasysa

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSTIMULANTS > IMMUNOSTIMULANTS

Caution

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
6449KMPNP	PEGINTERFERON ALFA-2A peginterferon alfa-2a 180 microgram/0.5 mL injection, 4 x 0.5 mL syringes (PI, CMI)	2	8	5	$1,145.60	$25.00	$25.00
	Available brands
	Pegasysa

Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSTIMULANTS > IMMUNOSTIMULANTS

Caution

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
9515TMPNP	PEGINTERFERON ALFA-2A peginterferon alfa-2a 135 microgram/0.5 mL injection, 4 x 0.5 mL syringes (PI, CMI)	2	8	5	$947.02	$25.00	$25.00
	Available brands
	Pegasysa

Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSTIMULANTS > IMMUNOSTIMULANTS

Caution

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
9516WMPNP	PEGINTERFERON ALFA-2A peginterferon alfa-2a 180 microgram/0.5 mL injection, 4 x 0.5 mL syringes (PI, CMI)	2	8	5	$1,096.72	$25.00	$25.00
	Available brands
	Pegasysa