Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
12922DMP	SILTUXIMAB siltuximab 400 mg injection, 1 vial (PI, CMI)	2	2	4	$6234.20	$31.60	$31.60
	Available brands
	Sylvant

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
12934RMP	SILTUXIMAB siltuximab 400 mg injection, 1 vial (PI, CMI)	2	2	4	$6282.57	$31.60	$31.60
	Available brands
	Sylvant