Source	S100 HSD Public
Body System	MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM

Note

Authority Required

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
11363CMP	NUSINERSEN nusinersen 12 mg/5 mL intrathecal injection, 5 mL vial (PI, CMI)	1	1	3	$104500.00	$31.60	$31.60
	Available brands
	Spinraza

Source	S100 HSD Public
Body System	MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM

Note

Authority Required

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
11378WMP	NUSINERSEN nusinersen 12 mg/5 mL intrathecal injection, 5 mL vial (PI, CMI)	1	1	0	$104500.00	$31.60	$31.60
	Available brands
	Spinraza

Source	S100 HSD Private
Body System	MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM

Note

Authority Required

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
11472TMP	NUSINERSEN nusinersen 12 mg/5 mL intrathecal injection, 5 mL vial (PI, CMI)	1	1	3	$104548.37	$31.60	$31.60
	Available brands
	Spinraza

Source	S100 HSD Private
Body System	MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM

Note

Authority Required

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
11476BMP	NUSINERSEN nusinersen 12 mg/5 mL intrathecal injection, 5 mL vial (PI, CMI)	1	1	0	$104548.37	$31.60	$31.60
	Available brands
	Spinraza

Source	S100 HSD Private
Body System	MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM

Note

Authority Required

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
12176WMP	NUSINERSEN nusinersen 12 mg/5 mL intrathecal injection, 5 mL vial (PI, CMI)	1	1	3	$104548.37	$31.60	$31.60
	Available brands
	Spinraza

Source	S100 HSD Public
Body System	MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM

Note

Authority Required

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
12177XMP	NUSINERSEN nusinersen 12 mg/5 mL intrathecal injection, 5 mL vial (PI, CMI)	1	1	3	$104500.00	$31.60	$31.60
	Available brands
	Spinraza

Source	S100 HSD Public
Body System	MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM

Note

Authority Required

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
12972RMP	NUSINERSEN nusinersen 12 mg/5 mL intrathecal injection, 5 mL vial (PI, CMI)	1	1	3	$104500.00	$31.60	$31.60
	Available brands
	Spinraza