GLECAPREVIR + PIBRENTASVIR

Source S100 HSD Public
Body System ANTIINFECTIVES FOR SYSTEMIC USE > ANTIVIRALS FOR SYSTEMIC USE > DIRECT ACTING ANTIVIRALS
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
11332KMPNP GLECAPREVIR + PIBRENTASVIR
glecaprevir 100 mg + pibrentasvir 40 mg tablet, 84 (PI, CMI)
1 84 1 $18666.67 $41.30 $41.30
Available brands
Maviret
space

GLECAPREVIR + PIBRENTASVIR

Source S100 HSD Public
Body System ANTIINFECTIVES FOR SYSTEMIC USE > ANTIVIRALS FOR SYSTEMIC USE > DIRECT ACTING ANTIVIRALS
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
11333LMPNP GLECAPREVIR + PIBRENTASVIR
glecaprevir 100 mg + pibrentasvir 40 mg tablet, 84 (PI, CMI)
1 84 3 $18666.67 $41.30 $41.30
Available brands
Maviret
space

GLECAPREVIR + PIBRENTASVIR

Source S100 HSD Private
Body System ANTIINFECTIVES FOR SYSTEMIC USE > ANTIVIRALS FOR SYSTEMIC USE > DIRECT ACTING ANTIVIRALS
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
11337QMPNP GLECAPREVIR + PIBRENTASVIR
glecaprevir 100 mg + pibrentasvir 40 mg tablet, 84 (PI, CMI)
1 84 3 $18714.45 $41.30 $41.30
Available brands
Maviret
space

GLECAPREVIR + PIBRENTASVIR

Source General Schedule
Body System ANTIINFECTIVES FOR SYSTEMIC USE > ANTIVIRALS FOR SYSTEMIC USE > DIRECT ACTING ANTIVIRALS
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
11344CMPNP GLECAPREVIR + PIBRENTASVIR
glecaprevir 100 mg + pibrentasvir 40 mg tablet, 84 (PI, CMI)
1 84 3 $18827.89 $41.30 $41.30
Available brands
Maviret
space

GLECAPREVIR + PIBRENTASVIR

Source S100 HSD Public
Body System ANTIINFECTIVES FOR SYSTEMIC USE > ANTIVIRALS FOR SYSTEMIC USE > DIRECT ACTING ANTIVIRALS
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
11345DMPNP GLECAPREVIR + PIBRENTASVIR
glecaprevir 100 mg + pibrentasvir 40 mg tablet, 84 (PI, CMI)
1 84 2 $18666.67 $41.30 $41.30
Available brands
Maviret
space

GLECAPREVIR + PIBRENTASVIR

Source S100 HSD Private
Body System ANTIINFECTIVES FOR SYSTEMIC USE > ANTIVIRALS FOR SYSTEMIC USE > DIRECT ACTING ANTIVIRALS
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
11346EMPNP GLECAPREVIR + PIBRENTASVIR
glecaprevir 100 mg + pibrentasvir 40 mg tablet, 84 (PI, CMI)
1 84 2 $18714.45 $41.30 $41.30
Available brands
Maviret
space

GLECAPREVIR + PIBRENTASVIR

Source General Schedule
Body System ANTIINFECTIVES FOR SYSTEMIC USE > ANTIVIRALS FOR SYSTEMIC USE > DIRECT ACTING ANTIVIRALS
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
11353MMPNP GLECAPREVIR + PIBRENTASVIR
glecaprevir 100 mg + pibrentasvir 40 mg tablet, 84 (PI, CMI)
1 84 1 $18827.89 $41.30 $41.30
Available brands
Maviret
space

GLECAPREVIR + PIBRENTASVIR

Source General Schedule
Body System ANTIINFECTIVES FOR SYSTEMIC USE > ANTIVIRALS FOR SYSTEMIC USE > DIRECT ACTING ANTIVIRALS
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
11354NMPNP GLECAPREVIR + PIBRENTASVIR
glecaprevir 100 mg + pibrentasvir 40 mg tablet, 84 (PI, CMI)
1 84 2 $18827.89 $41.30 $41.30
Available brands
Maviret
space

GLECAPREVIR + PIBRENTASVIR

Source S100 HSD Private
Body System ANTIINFECTIVES FOR SYSTEMIC USE > ANTIVIRALS FOR SYSTEMIC USE > DIRECT ACTING ANTIVIRALS
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
11355PMPNP GLECAPREVIR + PIBRENTASVIR
glecaprevir 100 mg + pibrentasvir 40 mg tablet, 84 (PI, CMI)
1 84 1 $18714.45 $41.30 $41.30
Available brands
Maviret
space


  • Legend
  • MPMedical Practitioner
  • NPNurse Practitioner