ONASEMNOGENE ABEPARVOVEC

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
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
12940CMP ONASEMNOGENE ABEPARVOVEC
onasemnogene abeparvovec 20 trillion vector genomes/mL injection [2 x 5.5 mL vials] (&) onasemnogene abeparvovec 20 trillion vector genomes/mL injection [3 x 8.3 mL vials], 1 pack (PI, CMI)
1 1 0 $2527773.87 $42.50 $42.50
Available brands
Zolgensma
space

ONASEMNOGENE ABEPARVOVEC

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
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
12941DMP ONASEMNOGENE ABEPARVOVEC
onasemnogene abeparvovec 20 trillion vector genomes/mL injection [2 x 5.5 mL vials] (&) onasemnogene abeparvovec 20 trillion vector genomes/mL injection [6 x 8.3 mL vials], 1 pack (PI, CMI)
1 1 0 $2527773.87 $42.50 $42.50
Available brands
Zolgensma
space

ONASEMNOGENE ABEPARVOVEC

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
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
12942EMP ONASEMNOGENE ABEPARVOVEC
onasemnogene abeparvovec 20 trillion vector genomes/mL injection [5.5 mL vial] (&) onasemnogene abeparvovec 20 trillion vector genomes/mL injection [4 x 8.3 mL vials], 1 pack (PI, CMI)
1 1 0 $2527773.87 $42.50 $42.50
Available brands
Zolgensma
space

ONASEMNOGENE ABEPARVOVEC

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
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
12949MMP ONASEMNOGENE ABEPARVOVEC
onasemnogene abeparvovec 20 trillion vector genomes/mL injection, 9 x 8.3 mL vials (PI, CMI)
1 1 0 $2527773.87 $42.50 $42.50
Available brands
Zolgensma
space

ONASEMNOGENE ABEPARVOVEC

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
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
12950NMP ONASEMNOGENE ABEPARVOVEC
onasemnogene abeparvovec 20 trillion vector genomes/mL injection [2 x 5.5 mL vials] (&) onasemnogene abeparvovec 20 trillion vector genomes/mL injection [4 x 8.3 mL vials], 1 pack (PI, CMI)
1 1 0 $2527773.87 $42.50 $42.50
Available brands
Zolgensma
space

ONASEMNOGENE ABEPARVOVEC

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
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
12951PMP ONASEMNOGENE ABEPARVOVEC
onasemnogene abeparvovec 20 trillion vector genomes/mL injection [5.5 mL vial] (&) onasemnogene abeparvovec 20 trillion vector genomes/mL injection [2 x 8.3 mL vials], 1 pack (PI, CMI)
1 1 0 $2527773.87 $42.50 $42.50
Available brands
Zolgensma
space

ONASEMNOGENE ABEPARVOVEC

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
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
12952QMP ONASEMNOGENE ABEPARVOVEC
onasemnogene abeparvovec 20 trillion vector genomes/mL injection [2 x 5.5 mL vials] (&) onasemnogene abeparvovec 20 trillion vector genomes/mL injection [7 x 8.3 mL vials], 1 pack (PI, CMI)
1 1 0 $2527773.87 $42.50 $42.50
Available brands
Zolgensma
space

ONASEMNOGENE ABEPARVOVEC

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
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
12954TMP ONASEMNOGENE ABEPARVOVEC
onasemnogene abeparvovec 20 trillion vector genomes/mL injection, 7 x 8.3 mL vials (PI, CMI)
1 1 0 $2527773.87 $42.50 $42.50
Available brands
Zolgensma
space

ONASEMNOGENE ABEPARVOVEC

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
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
12955WMP ONASEMNOGENE ABEPARVOVEC
onasemnogene abeparvovec 20 trillion vector genomes/mL injection [2 x 5.5 mL vials] (&) onasemnogene abeparvovec 20 trillion vector genomes/mL injection [8.3 mL vial], 1 pack (PI, CMI)
1 1 0 $2527773.87 $42.50 $42.50
Available brands
Zolgensma
space

ONASEMNOGENE ABEPARVOVEC

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
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
12956XMP ONASEMNOGENE ABEPARVOVEC
onasemnogene abeparvovec 20 trillion vector genomes/mL injection [5.5 mL vial] (&) onasemnogene abeparvovec 20 trillion vector genomes/mL injection [7 x 8.3 mL vials], 1 pack (PI, CMI)
1 1 0 $2527773.87 $42.50 $42.50
Available brands
Zolgensma
space

ONASEMNOGENE ABEPARVOVEC

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
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
12957YMP ONASEMNOGENE ABEPARVOVEC
onasemnogene abeparvovec 20 trillion vector genomes/mL injection, 2 x 8.3 mL vials (PI, CMI)
1 1 0 $2527773.87 $42.50 $42.50
Available brands
Zolgensma
space

ONASEMNOGENE ABEPARVOVEC

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
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
12958BMP ONASEMNOGENE ABEPARVOVEC
onasemnogene abeparvovec 20 trillion vector genomes/mL injection [2 x 5.5 mL vials] (&) onasemnogene abeparvovec 20 trillion vector genomes/mL injection [2 x 8.3 mL vials], 1 pack (PI, CMI)
1 1 0 $2527773.87 $42.50 $42.50
Available brands
Zolgensma
space

ONASEMNOGENE ABEPARVOVEC

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
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
12961EMP ONASEMNOGENE ABEPARVOVEC
onasemnogene abeparvovec 20 trillion vector genomes/mL injection, 3 x 8.3 mL vials (PI, CMI)
1 1 0 $2527773.87 $42.50 $42.50
Available brands
Zolgensma
space

ONASEMNOGENE ABEPARVOVEC

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
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
12962FMP ONASEMNOGENE ABEPARVOVEC
onasemnogene abeparvovec 20 trillion vector genomes/mL injection, 5 x 8.3 mL vials (PI, CMI)
1 1 0 $2527773.87 $42.50 $42.50
Available brands
Zolgensma
space

ONASEMNOGENE ABEPARVOVEC

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
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
12963GMP ONASEMNOGENE ABEPARVOVEC
onasemnogene abeparvovec 20 trillion vector genomes/mL injection [2 x 5.5 mL vials] (&) onasemnogene abeparvovec 20 trillion vector genomes/mL injection [5 x 8.3 mL vials], 1 pack (PI, CMI)
1 1 0 $2527773.87 $42.50 $42.50
Available brands
Zolgensma
space

ONASEMNOGENE ABEPARVOVEC

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
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
12964HMP ONASEMNOGENE ABEPARVOVEC
onasemnogene abeparvovec 20 trillion vector genomes/mL injection [5.5 mL vial] (&) onasemnogene abeparvovec 20 trillion vector genomes/mL injection [8 x 8.3 mL vials], 1 pack (PI, CMI)
1 1 0 $2527773.87 $42.50 $42.50
Available brands
Zolgensma
space

ONASEMNOGENE ABEPARVOVEC

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
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
12971QMP ONASEMNOGENE ABEPARVOVEC
onasemnogene abeparvovec 20 trillion vector genomes/mL injection, 4 x 8.3 mL vials (PI, CMI)
1 1 0 $2527773.87 $42.50 $42.50
Available brands
Zolgensma
space

ONASEMNOGENE ABEPARVOVEC

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
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
12973TMP ONASEMNOGENE ABEPARVOVEC
onasemnogene abeparvovec 20 trillion vector genomes/mL injection, 6 x 8.3 mL vials (PI, CMI)
1 1 0 $2527773.87 $42.50 $42.50
Available brands
Zolgensma
space

ONASEMNOGENE ABEPARVOVEC

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
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
12974WMP ONASEMNOGENE ABEPARVOVEC
onasemnogene abeparvovec 20 trillion vector genomes/mL injection, 8 x 8.3 mL vials (PI, CMI)
1 1 0 $2527773.87 $42.50 $42.50
Available brands
Zolgensma
space

ONASEMNOGENE ABEPARVOVEC

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
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
12975XMP ONASEMNOGENE ABEPARVOVEC
onasemnogene abeparvovec 20 trillion vector genomes/mL injection [5.5 mL vial] (&) onasemnogene abeparvovec 20 trillion vector genomes/mL injection [6 x 8.3 mL vials], 1 pack (PI, CMI)
1 1 0 $2527773.87 $42.50 $42.50
Available brands
Zolgensma
space

ONASEMNOGENE ABEPARVOVEC

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
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
12976YMP ONASEMNOGENE ABEPARVOVEC
onasemnogene abeparvovec 20 trillion vector genomes/mL injection [5.5 mL vial] (&) onasemnogene abeparvovec 20 trillion vector genomes/mL injection [5 x 8.3 mL vials], 1 pack (PI, CMI)
1 1 0 $2527773.87 $42.50 $42.50
Available brands
Zolgensma
space

ONASEMNOGENE ABEPARVOVEC

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
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
12977BMP ONASEMNOGENE ABEPARVOVEC
onasemnogene abeparvovec 20 trillion vector genomes/mL injection [5.5 mL vial] (&) onasemnogene abeparvovec 20 trillion vector genomes/mL injection [3 x 8.3 mL vials], 1 pack (PI, CMI)
1 1 0 $2527773.87 $42.50 $42.50
Available brands
Zolgensma
space


  • Legend
  • MPMedical Practitioner