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 $80.43 $30.00 $30.00
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 $19.01 $20.32 $23.61
Available brands
Raloveraa
Proveraa
* Additional charge for this brand is $6.70B
1 30 2 $25.71 $20.32 $30.31
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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 $17.65 $18.96 $22.25
Available brands
Raloveraa
Proveraa
* Additional charge for this brand is $4.55B
1 56 2 $22.20 $18.96 $26.80
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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 $35.04 $30.00 $30.00
Available brands
Raloveraa
Proveraa
* Additional charge for this brand is $6.70B
1 100 2 $41.74 $30.00 $36.70
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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 $72.17 $30.00 $30.00
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 $97.84 $30.00 $30.00
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 $97.84 $30.00 $30.00
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)
1 1 1 $26.27 $27.58 $30.00
Available brands
Depo-Raloveraa
Depo-Proveraa
* Additional charge for this brand is $7.00B
1 1 1 $33.27 $27.58 $37.00
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  • Legend
  • BBrand premium applies
  • aBrand equivalent a
  • MPMedical Practitioner
  • NPNurse Practitioner