DEFERASIROX

Source S100 HSD Public
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11231DMP DEFERASIROX
deferasirox 500 mg dispersible tablet, 28 (PI, CMI)
6 168 2 $2374.68 $42.50 $42.50
Available brands
Deferasirox Juno
space

DEFERASIROX

Source S100 HSD Private
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11232EMP DEFERASIROX
deferasirox 500 mg dispersible tablet, 28 (PI, CMI)
6 168 2 $2422.52 $42.50 $42.50
Available brands
Deferasirox Juno
space

DEFERASIROX

Source S100 HSD Public
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11234GMP DEFERASIROX
deferasirox 500 mg dispersible tablet, 28 (PI, CMI)
6 168 5 $2374.68 $42.50 $42.50
Available brands
Deferasirox Juno
space

DEFERASIROX

Source S100 HSD Public
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11235HMP DEFERASIROX
deferasirox 125 mg dispersible tablet, 28 (PI, CMI)
6 168 2 $593.70 $42.50 $42.50
Available brands
Deferasirox Juno
space

DEFERASIROX

Source S100 HSD Private
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11236JMP DEFERASIROX
deferasirox 125 mg dispersible tablet, 28 (PI, CMI)
6 168 2 $625.28 $42.50 $42.50
Available brands
Deferasirox Juno
space

DEFERASIROX

Source S100 HSD Private
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11238LMP DEFERASIROX
deferasirox 250 mg dispersible tablet, 28 (PI, CMI)
6 168 2 $1235.18 $42.50 $42.50
Available brands
Deferasirox Juno
space

DEFERASIROX

Source S100 HSD Public
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11239MMP DEFERASIROX
deferasirox 250 mg dispersible tablet, 28 (PI, CMI)
6 168 2 $1187.34 $42.50 $42.50
Available brands
Deferasirox Juno
space

DEFERASIROX

Source S100 HSD Public
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11240NMP DEFERASIROX
deferasirox 250 mg dispersible tablet, 28 (PI, CMI)
6 168 5 $1187.34 $42.50 $42.50
Available brands
Deferasirox Juno
space

DEFERASIROX

Source S100 HSD Private
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11241PMP DEFERASIROX
deferasirox 125 mg dispersible tablet, 28 (PI, CMI)
6 168 2 $625.28 $42.50 $42.50
Available brands
Deferasirox Juno
space

DEFERASIROX

Source S100 HSD Private
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11243RMP DEFERASIROX
deferasirox 500 mg dispersible tablet, 28 (PI, CMI)
6 168 2 $2422.52 $42.50 $42.50
Available brands
Deferasirox Juno
space

DEFERASIROX

Source S100 HSD Private
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11244TMP DEFERASIROX
deferasirox 250 mg dispersible tablet, 28 (PI, CMI)
6 168 2 $1235.18 $42.50 $42.50
Available brands
Deferasirox Juno
space

DEFERASIROX

Source S100 HSD Public
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11247YMP DEFERASIROX
deferasirox 125 mg dispersible tablet, 28 (PI, CMI)
6 168 5 $593.70 $42.50 $42.50
Available brands
Deferasirox Juno
space

DEFERASIROX

Source S100 HSD Private
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11496CMP DEFERASIROX
deferasirox 360 mg tablet, 30 (PI, CMI)
6 180 5 $2592.14 $42.50 $42.50
Available brands
CIPLA DEFERASIROXa
DEFERASIROX-TEVAa
Deferasirox ARXa
Deferasirox Sandoza
Eferasa
Jadenua
Pharmacor Deferasirox FCa
space

DEFERASIROX

Source S100 HSD Public
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11499FMP DEFERASIROX
deferasirox 90 mg tablet, 30 (PI, CMI)
6 180 5 $636.12 $42.50 $42.50
Available brands
CIPLA DEFERASIROXa
DEFERASIROX-TEVAa
Deferasirox ARXa
Deferasirox Sandoza
Eferasa
Jadenua
Pharmacor Deferasirox FCa
space

DEFERASIROX

Source S100 HSD Public
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11500GMP DEFERASIROX
deferasirox 180 mg tablet, 30 (PI, CMI)
6 180 2 $1272.18 $42.50 $42.50
Available brands
CIPLA DEFERASIROXa
DEFERASIROX-TEVAa
Deferasirox ARXa
Deferasirox Sandoza
Eferasa
Jadenua
Pharmacor Deferasirox FCa
space

DEFERASIROX

Source S100 HSD Private
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11510TMP DEFERASIROX
deferasirox 180 mg tablet, 30 (PI, CMI)
6 180 2 $1320.02 $42.50 $42.50
Available brands
CIPLA DEFERASIROXa
DEFERASIROX-TEVAa
Deferasirox ARXa
Deferasirox Sandoza
Eferasa
Jadenua
Pharmacor Deferasirox FCa
space

DEFERASIROX

Source S100 HSD Private
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11511WMP DEFERASIROX
deferasirox 360 mg tablet, 30 (PI, CMI)
6 180 2 $2592.14 $42.50 $42.50
Available brands
CIPLA DEFERASIROXa
DEFERASIROX-TEVAa
Deferasirox ARXa
Deferasirox Sandoza
Eferasa
Jadenua
Pharmacor Deferasirox FCa
space

DEFERASIROX

Source S100 HSD Public
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11519GMP DEFERASIROX
deferasirox 90 mg tablet, 30 (PI, CMI)
6 180 2 $636.12 $42.50 $42.50
Available brands
CIPLA DEFERASIROXa
DEFERASIROX-TEVAa
Deferasirox ARXa
Deferasirox Sandoza
Eferasa
Jadenua
Pharmacor Deferasirox FCa
space

DEFERASIROX

Source S100 HSD Public
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11533BMP DEFERASIROX
deferasirox 360 mg tablet, 30 (PI, CMI)
6 180 5 $2544.30 $42.50 $42.50
Available brands
CIPLA DEFERASIROXa
DEFERASIROX-TEVAa
Deferasirox ARXa
Deferasirox Sandoza
Eferasa
Jadenua
Pharmacor Deferasirox FCa
space

DEFERASIROX

Source S100 HSD Public
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11534CMP DEFERASIROX
deferasirox 90 mg tablet, 30 (PI, CMI)
6 180 2 $636.12 $42.50 $42.50
Available brands
CIPLA DEFERASIROXa
DEFERASIROX-TEVAa
Deferasirox ARXa
Deferasirox Sandoza
Eferasa
Jadenua
Pharmacor Deferasirox FCa
space

DEFERASIROX

Source S100 HSD Public
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11535DMP DEFERASIROX
deferasirox 180 mg tablet, 30 (PI, CMI)
6 180 2 $1272.18 $42.50 $42.50
Available brands
CIPLA DEFERASIROXa
DEFERASIROX-TEVAa
Deferasirox ARXa
Deferasirox Sandoza
Eferasa
Jadenua
Pharmacor Deferasirox FCa
space

DEFERASIROX

Source S100 HSD Public
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11536EMP DEFERASIROX
deferasirox 360 mg tablet, 30 (PI, CMI)
6 180 2 $2544.30 $42.50 $42.50
Available brands
CIPLA DEFERASIROXa
DEFERASIROX-TEVAa
Deferasirox ARXa
Deferasirox Sandoza
Eferasa
Jadenua
Pharmacor Deferasirox FCa
space

DEFERASIROX

Source S100 HSD Private
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11545PMP DEFERASIROX
deferasirox 90 mg tablet, 30 (PI, CMI)
6 180 5 $669.38 $42.50 $42.50
Available brands
CIPLA DEFERASIROXa
DEFERASIROX-TEVAa
Deferasirox ARXa
Deferasirox Sandoza
Eferasa
Jadenua
Pharmacor Deferasirox FCa
space

DEFERASIROX

Source S100 HSD Private
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11546QMP DEFERASIROX
deferasirox 180 mg tablet, 30 (PI, CMI)
6 180 5 $1320.02 $42.50 $42.50
Available brands
CIPLA DEFERASIROXa
DEFERASIROX-TEVAa
Deferasirox ARXa
Deferasirox Sandoza
Eferasa
Jadenua
Pharmacor Deferasirox FCa
space

DEFERASIROX

Source S100 HSD Private
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11547RMP DEFERASIROX
deferasirox 360 mg tablet, 30 (PI, CMI)
6 180 2 $2592.14 $42.50 $42.50
Available brands
CIPLA DEFERASIROXa
DEFERASIROX-TEVAa
Deferasirox ARXa
Deferasirox Sandoza
Eferasa
Jadenua
Pharmacor Deferasirox FCa
space

DEFERASIROX

Source S100 HSD Private
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11548TMP DEFERASIROX
deferasirox 90 mg tablet, 30 (PI, CMI)
6 180 2 $669.38 $42.50 $42.50
Available brands
CIPLA DEFERASIROXa
DEFERASIROX-TEVAa
Deferasirox ARXa
Deferasirox Sandoza
Eferasa
Jadenua
Pharmacor Deferasirox FCa
space

DEFERASIROX

Source S100 HSD Public
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11555EMP DEFERASIROX
deferasirox 360 mg tablet, 30 (PI, CMI)
6 180 2 $2544.30 $42.50 $42.50
Available brands
CIPLA DEFERASIROXa
DEFERASIROX-TEVAa
Deferasirox ARXa
Deferasirox Sandoza
Eferasa
Jadenua
Pharmacor Deferasirox FCa
space

DEFERASIROX

Source S100 HSD Public
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11556FMP DEFERASIROX
deferasirox 180 mg tablet, 30 (PI, CMI)
6 180 5 $1272.18 $42.50 $42.50
Available brands
CIPLA DEFERASIROXa
DEFERASIROX-TEVAa
Deferasirox ARXa
Deferasirox Sandoza
Eferasa
Jadenua
Pharmacor Deferasirox FCa
space

DEFERASIROX

Source S100 HSD Private
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11557GMP DEFERASIROX
deferasirox 180 mg tablet, 30 (PI, CMI)
6 180 2 $1320.02 $42.50 $42.50
Available brands
CIPLA DEFERASIROXa
DEFERASIROX-TEVAa
Deferasirox ARXa
Deferasirox Sandoza
Eferasa
Jadenua
Pharmacor Deferasirox FCa
space

DEFERASIROX

Source S100 HSD Private
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
11558HMP DEFERASIROX
deferasirox 90 mg tablet, 30 (PI, CMI)
6 180 2 $669.38 $42.50 $42.50
Available brands
CIPLA DEFERASIROXa
DEFERASIROX-TEVAa
Deferasirox ARXa
Deferasirox Sandoza
Eferasa
Jadenua
Pharmacor Deferasirox FCa
space

DEFERASIROX

Source S100 HSD Public
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
5654NMP DEFERASIROX
deferasirox 125 mg dispersible tablet, 28 (PI, CMI)
6 168 2 $593.70 $42.50 $42.50
Available brands
Deferasirox Juno
space

DEFERASIROX

Source S100 HSD Public
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
5655PMP DEFERASIROX
deferasirox 250 mg dispersible tablet, 28 (PI, CMI)
6 168 2 $1187.34 $42.50 $42.50
Available brands
Deferasirox Juno
space

DEFERASIROX

Source S100 HSD Public
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
5656QMP DEFERASIROX
deferasirox 500 mg dispersible tablet, 28 (PI, CMI)
6 168 2 $2374.68 $42.50 $42.50
Available brands
Deferasirox Juno
space

DEFERASIROX

Source S100 HSD Private
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
6499CMP DEFERASIROX
deferasirox 125 mg dispersible tablet, 28 (PI, CMI)
6 168 5 $625.28 $42.50 $42.50
Available brands
Deferasirox Juno
space

DEFERASIROX

Source S100 HSD Private
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
6500DMP DEFERASIROX
deferasirox 250 mg dispersible tablet, 28 (PI, CMI)
6 168 5 $1235.18 $42.50 $42.50
Available brands
Deferasirox Juno
space

DEFERASIROX

Source S100 HSD Private
Body System VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS
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
9600GMP DEFERASIROX
deferasirox 500 mg dispersible tablet, 28 (PI, CMI)
6 168 5 $2422.52 $42.50 $42.50
Available brands
Deferasirox Juno
space


  • Legend
  • aBrand equivalent a
  • MPMedical Practitioner