Source	S100 HSD Private
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
6204MMPNP	EPOETIN ALFA epoetin alfa 2000 units/0.5 mL injection, 6 x 0.5 mL syringes (PI, CMI)	2	12	5	$347.54	$25.00	$25.00
	Available brands
	Eprex 2000

Source	S100 HSD Private
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
6205NMPNP	EPOETIN ALFA epoetin alfa 3000 units/0.3 mL injection, 6 x 0.3 mL syringes (PI, CMI)	2	12	5	$445.88	$25.00	$25.00
	Available brands
	Eprex 3000

Source	S100 HSD Private
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
6206PMPNP	EPOETIN ALFA epoetin alfa 4000 units/0.4 mL injection, 6 x 0.4 mL syringes (PI, CMI)	2	12	5	$565.42	$25.00	$25.00
	Available brands
	Eprex 4000

Source	S100 HSD Private
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
6207QMPNP	EPOETIN ALFA epoetin alfa 10 000 units/mL injection, 6 x 1 mL syringes (PI, CMI)	2	12	5	$1,290.32	$25.00	$25.00
	Available brands
	Eprex 10000

Source	S100 HSD Private
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
6251BMPNP	EPOETIN ALFA epoetin alfa 1000 units/0.5 mL injection, 6 x 0.5 mL syringes (PI, CMI)	2	12	5	$191.90	$25.00	$25.00
	Available brands
	Eprex 1000

Source	S100 HSD Private
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
6302QMPNP	EPOETIN ALFA epoetin alfa 5000 units/0.5 mL injection, 6 x 0.5 mL syringes (PI, CMI)	2	12	5	$701.74	$25.00	$25.00
	Available brands
	Eprex 5000