Source	S100 HSD Public
Body System	VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS

Authority Required (STREAMLINED)

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
5661YMP	DESFERRIOXAMINE desferrioxamine mesilate 2 g injection, 1 vial (PI, CMI)	60	60	5	$2614.80	$31.60	$31.60
	Available brands
	DBL Desferrioxamine Mesilate

Source	S100 HSD Public
Body System	VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS

Authority Required (STREAMLINED)

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
5662BMP	DESFERRIOXAMINE desferrioxamine mesilate 500 mg injection, 10 vials (PI, CMI)	40	400	5	$5555.20	$31.60	$31.60
	Available brands
	DBL Desferrioxamine Mesilate

Source	S100 HSD Private
Body System	VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS

Authority Required (STREAMLINED)

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
6113RMP	DESFERRIOXAMINE desferrioxamine mesilate 500 mg injection, 10 vials (PI, CMI)	40	400	5	$5603.57	$31.60	$31.60
	Available brands
	DBL Desferrioxamine Mesilate

Source	S100 HSD Private
Body System	VARIOUS > ALL OTHER THERAPEUTIC PRODUCTS > ALL OTHER THERAPEUTIC PRODUCTS

Authority Required (STREAMLINED)

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
6270BMP	DESFERRIOXAMINE desferrioxamine mesilate 2 g injection, 1 vial (PI, CMI)	60	60	5	$2663.37	$31.60	$31.60
	Available brands
	DBL Desferrioxamine Mesilate