Source	S100 HSD Public
Body System	ALIMENTARY TRACT AND METABOLISM > OTHER ALIMENTARY TRACT AND METABOLISM PRODUCTS > OTHER ALIMENTARY TRACT AND METABOLISM PRODUCTS

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
11793QMP	TEDUGLUTIDE teduglutide 5 mg injection [28 vials] (&) inert substance diluent [28 x 0.5 mL syringes], 1 pack (PI, CMI)	1	28	11	$19710.60	$31.60	$31.60
	Available brands
	Revestive

Source	S100 HSD Public
Body System	ALIMENTARY TRACT AND METABOLISM > OTHER ALIMENTARY TRACT AND METABOLISM PRODUCTS > OTHER ALIMENTARY TRACT AND METABOLISM PRODUCTS

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
11794RMP	TEDUGLUTIDE teduglutide 5 mg injection [28 vials] (&) inert substance diluent [28 x 0.5 mL syringes], 1 pack (PI, CMI)	1	28	5	$19710.60	$31.60	$31.60
	Available brands
	Revestive

Source	S100 HSD Private
Body System	ALIMENTARY TRACT AND METABOLISM > OTHER ALIMENTARY TRACT AND METABOLISM PRODUCTS > OTHER ALIMENTARY TRACT AND METABOLISM PRODUCTS

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
11795TMP	TEDUGLUTIDE teduglutide 5 mg injection [28 vials] (&) inert substance diluent [28 x 0.5 mL syringes], 1 pack (PI, CMI)	1	28	11	$19759.48	$31.60	$31.60
	Available brands
	Revestive

Source	S100 HSD Private
Body System	ALIMENTARY TRACT AND METABOLISM > OTHER ALIMENTARY TRACT AND METABOLISM PRODUCTS > OTHER ALIMENTARY TRACT AND METABOLISM PRODUCTS

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
11806JMP	TEDUGLUTIDE teduglutide 5 mg injection [28 vials] (&) inert substance diluent [28 x 0.5 mL syringes], 1 pack (PI, CMI)	1	28	5	$19759.48	$31.60	$31.60
	Available brands
	Revestive

Source	S100 HSD Public
Body System	ALIMENTARY TRACT AND METABOLISM > OTHER ALIMENTARY TRACT AND METABOLISM PRODUCTS > OTHER ALIMENTARY TRACT AND METABOLISM PRODUCTS

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
11808LMP	TEDUGLUTIDE teduglutide 5 mg injection [28 vials] (&) inert substance diluent [28 x 0.5 mL syringes], 1 pack (PI, CMI)	1	28	0	$19710.60	$31.60	$31.60
	Available brands
	Revestive

Source	S100 HSD Private
Body System	ALIMENTARY TRACT AND METABOLISM > OTHER ALIMENTARY TRACT AND METABOLISM PRODUCTS > OTHER ALIMENTARY TRACT AND METABOLISM PRODUCTS

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
11812QMP	TEDUGLUTIDE teduglutide 5 mg injection [28 vials] (&) inert substance diluent [28 x 0.5 mL syringes], 1 pack (PI, CMI)	1	28	0	$19759.48	$31.60	$31.60
	Available brands
	Revestive