MEDROXYPROGESTERONE

Source General Schedule
Body System GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > PROGESTOGENS
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
13849XMPNP MEDROXYPROGESTERONE
medroxyprogesterone acetate 10 mg tablet, 30 (PI, CMI)
2 60 2 $27.21 $28.66 $31.60
Available brands
Raloveraa
Proveraa
* Additional charge for this brand is $13.40B
2 60 2 $40.61 $28.66 $45.00
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MEDROXYPROGESTERONE

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ENDOCRINE THERAPY > HORMONES AND RELATED 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
13881NMP MEDROXYPROGESTERONE
medroxyprogesterone acetate 200 mg tablet, 60 (PI, CMI)
2 120 2 $183.13 $31.60 $31.60
Available brands
Provera
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MEDROXYPROGESTERONE

Source General Schedule
Body System GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > PROGESTOGENS
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
13928CMP MEDROXYPROGESTERONE
medroxyprogesterone acetate 10 mg tablet, 100 (PI, CMI)
2 200 2 $59.27 $31.60 $31.60
Available brands
Raloveraa
Proveraa
* Additional charge for this brand is $13.40B
2 200 2 $72.67 $31.60 $45.00
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MEDROXYPROGESTERONE

Source General Schedule
Body System GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > PROGESTOGENS
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
13956MMPNP MEDROXYPROGESTERONE
medroxyprogesterone acetate 5 mg tablet, 56 (PI, CMI)
2 112 2 $24.43 $25.88 $29.33
Available brands
Raloveraa
Proveraa
* Additional charge for this brand is $9.16B
2 112 2 $33.59 $25.88 $38.49
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MEDROXYPROGESTERONE

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ENDOCRINE THERAPY > HORMONES AND RELATED 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
13961TMP MEDROXYPROGESTERONE
medroxyprogesterone acetate 250 mg tablet, 60 (PI, CMI)
2 120 2 $188.43 $31.60 $31.60
Available brands
Provera
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MEDROXYPROGESTERONE

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ENDOCRINE THERAPY > HORMONES AND RELATED 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
14038WMP MEDROXYPROGESTERONE
medroxyprogesterone acetate 500 mg tablet, 30 (PI, CMI)
2 60 2 $188.43 $31.60 $31.60
Available brands
Provera
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MEDROXYPROGESTERONE

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ENDOCRINE THERAPY > HORMONES AND RELATED 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
14067JMP MEDROXYPROGESTERONE
medroxyprogesterone acetate 100 mg tablet, 100 (PI, CMI)
2 200 2 $161.61 $31.60 $31.60
Available brands
Provera
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MEDROXYPROGESTERONE

Source General Schedule
Body System GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > HORMONAL CONTRACEPTIVES FOR SYSTEMIC USE
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
14160GMPNP MEDROXYPROGESTERONE
medroxyprogesterone acetate 150 mg/mL injection, 1 mL syringe (PI, CMI)
1 1 1 $27.59 $29.04 $31.60
Available brands
Depo-Proveraa
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MEDROXYPROGESTERONE

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ENDOCRINE THERAPY > HORMONES AND RELATED 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
2316XMP MEDROXYPROGESTERONE
medroxyprogesterone acetate 200 mg tablet, 60 (PI, CMI)
1 60 2 $96.64 $31.60 $31.60
Available brands
Provera
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MEDROXYPROGESTERONE

Source General Schedule
Body System GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > PROGESTOGENS
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
2321EMPNP MEDROXYPROGESTERONE
medroxyprogesterone acetate 10 mg tablet, 30 (PI, CMI)
1 30 2 $20.33 $21.78 $25.23
Available brands
Raloveraa
Proveraa
* Additional charge for this brand is $6.70B
1 30 2 $27.03 $21.78 $31.93
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MEDROXYPROGESTERONE

Source General Schedule
Body System GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > PROGESTOGENS
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
2323GMPNP MEDROXYPROGESTERONE
medroxyprogesterone acetate 5 mg tablet, 56 (PI, CMI)
1 56 2 $18.94 $20.39 $23.84
Available brands
Raloveraa
Proveraa
* Additional charge for this brand is $4.58B
1 56 2 $23.52 $20.39 $28.42
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MEDROXYPROGESTERONE

Source General Schedule
Body System GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > PROGESTOGENS
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
2722GMP MEDROXYPROGESTERONE
medroxyprogesterone acetate 10 mg tablet, 100 (PI, CMI)
1 100 2 $36.36 $31.60 $31.60
Available brands
Raloveraa
Proveraa
* Additional charge for this brand is $6.70B
1 100 2 $43.06 $31.60 $38.30
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MEDROXYPROGESTERONE

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ENDOCRINE THERAPY > HORMONES AND RELATED 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
2725KMP MEDROXYPROGESTERONE
medroxyprogesterone acetate 100 mg tablet, 100 (PI, CMI)
1 100 2 $86.39 $31.60 $31.60
Available brands
Provera
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MEDROXYPROGESTERONE

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ENDOCRINE THERAPY > HORMONES AND RELATED 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
2727MMP MEDROXYPROGESTERONE
medroxyprogesterone acetate 250 mg tablet, 60 (PI, CMI)
1 60 2 $99.16 $31.60 $31.60
Available brands
Provera
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MEDROXYPROGESTERONE

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ENDOCRINE THERAPY > HORMONES AND RELATED 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
2728NMP MEDROXYPROGESTERONE
medroxyprogesterone acetate 500 mg tablet, 30 (PI, CMI)
1 30 2 $99.16 $31.60 $31.60
Available brands
Provera
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MEDROXYPROGESTERONE

Source General Schedule
Body System GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > HORMONAL CONTRACEPTIVES FOR SYSTEMIC USE
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
3118DMPNP MEDROXYPROGESTERONE
medroxyprogesterone acetate 150 mg/mL injection, 1 mL vial (PI, CMI)
Available brands
Depo-Proveraa
* Additional charge for this brand is $7.00B
1 1 1 $34.59 $29.04 $38.60
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  • Legend
  • BBrand premium applies
  • aBrand equivalent a
  • MPMedical Practitioner
  • NPNurse Practitioner