Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

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
14883HMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL pen device (PI, CMI)	1	1	0	$226.31	$31.60	$31.60
	Available brands
	Xolaira

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

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
14884JMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL pen device (PI, CMI)	1	1	7	$209.07	$31.60	$31.60
	Available brands
	Xolaira

Source	S100 HSD Private
Body System	DERMATOLOGICALS > OTHER DERMATOLOGICAL PREPARATIONS > OTHER DERMATOLOGICAL PREPARATIONS

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
14903JMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL pen device (PI, CMI)	2	2	2	$443.74	$31.60	$31.60
	Available brands
	Xolaira

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

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
14922JMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL pen device (PI, CMI)	1	1	5	$209.07	$31.60	$31.60
	Available brands
	Xolaira

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

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
14923KMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL pen device (PI, CMI)	1	1	7	$226.31	$31.60	$31.60
	Available brands
	Xolaira

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

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
14928QMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL pen device (PI, CMI)	1	1	5	$226.31	$31.60	$31.60
	Available brands
	Xolaira

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

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
14929RMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL pen device (PI, CMI)	1	1	0	$209.07	$31.60	$31.60
	Available brands
	Xolaira

Source	S100 HSD Public
Body System	DERMATOLOGICALS > OTHER DERMATOLOGICAL PREPARATIONS > OTHER DERMATOLOGICAL PREPARATIONS

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
14937EMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL pen device (PI, CMI)	2	2	5	$418.14	$31.60	$31.60
	Available brands
	Xolaira

Source	S100 HSD Private
Body System	DERMATOLOGICALS > OTHER DERMATOLOGICAL PREPARATIONS > OTHER DERMATOLOGICAL PREPARATIONS

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
14938FMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL pen device (PI, CMI)	2	2	5	$443.74	$31.60	$31.60
	Available brands
	Xolaira

Source	S100 HSD Public
Body System	DERMATOLOGICALS > OTHER DERMATOLOGICAL PREPARATIONS > OTHER DERMATOLOGICAL PREPARATIONS

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
14945NMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL pen device (PI, CMI)	2	2	2	$418.14	$31.60	$31.60
	Available brands
	Xolaira