AFLIBERCEPT

Source General Schedule
Body System SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS
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
12132MMP AFLIBERCEPT
aflibercept 3.6 mg/0.09 mL injection, 0.09 mL syringe (PI, CMI)
1 1 2 $932.76 $30.00 $30.00
Available brands
Eyleaa
space

AFLIBERCEPT

Source General Schedule
Body System SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS
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
12141BMP AFLIBERCEPT
aflibercept 3.6 mg/0.09 mL injection, 0.09 mL syringe (PI, CMI)
1 1 2 $932.76 $30.00 $30.00
Available brands
Eyleaa
space

AFLIBERCEPT

Source General Schedule
Body System SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS
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
12152NMP AFLIBERCEPT
aflibercept 3.6 mg/0.09 mL injection, 0.09 mL syringe (PI, CMI)
1 1 2 $932.76 $30.00 $30.00
Available brands
Eyleaa
space

AFLIBERCEPT

Source General Schedule
Body System SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS
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
12153PMP AFLIBERCEPT
aflibercept 3.6 mg/0.09 mL injection, 0.09 mL syringe (PI, CMI)
1 1 5 $932.76 $30.00 $30.00
Available brands
Eyleaa
space

AFLIBERCEPT

Source General Schedule
Body System SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS
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
13139MMP AFLIBERCEPT
aflibercept 3.6 mg/0.09 mL injection, 0.09 mL syringe (PI, CMI)
1 1 2 $932.76 $30.00 $30.00
Available brands
Eyleaa
space

AFLIBERCEPT

Source General Schedule
Body System SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS
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
13141PMP AFLIBERCEPT
aflibercept 3.6 mg/0.09 mL injection, 0.09 mL syringe (PI, CMI)
1 1 2 $932.76 $30.00 $30.00
Available brands
Eyleaa
space

AFLIBERCEPT

Source General Schedule
Body System SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS
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
13150DMP AFLIBERCEPT
aflibercept 3.6 mg/0.09 mL injection, 0.09 mL syringe (PI, CMI)
1 1 5 $932.76 $30.00 $30.00
Available brands
Eyleaa
space

AFLIBERCEPT

Source General Schedule
Body System SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS
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
13167BMP AFLIBERCEPT
aflibercept 3.6 mg/0.09 mL injection, 0.09 mL syringe (PI, CMI)
1 1 2 $932.76 $30.00 $30.00
Available brands
Eyleaa
space


  • Legend
  • aBrand equivalent a
  • MPMedical Practitioner