TERIPARATIDE

TERIPARATIDE (14093R)

teriparatide 250 microgram/mL injection, 2.4 mL pen device
14093R
Body System:
Manner of administration:Injection
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 12492)

Indication: Severe established osteoporosis
Treatment phase: Initial treatment

Restriction (Streamlined authority code: 12270)

Indication: Severe established osteoporosis
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 5 DPMQ: $177.63 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Teriparatide Lupin
Terrosa

TERIPARATIDE (14482F)

teriparatide 250 microgram/mL injection, 2.4 mL pen device
14482F
Body System:
Manner of administration:Injection
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 15536)

Indication: Severe established osteoporosis
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 2 # of repeats: 2 DPMQ: $346.48 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Teriparatide Lupin
Terrosa

TERIPARATIDE (15152L)

teriparatide 250 microgram/mL injection, 2.4 mL cartridge
15152L
Body System:
Manner of administration:Injection
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 12492)

Indication: Severe established osteoporosis
Treatment phase: Initial treatment

Restriction (Streamlined authority code: 12270)

Indication: Severe established osteoporosis
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 5 DPMQ: $177.63 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Ritosa

TERIPARATIDE (15188J)

teriparatide 250 microgram/mL injection, 2.4 mL cartridge
15188J
Body System:
Manner of administration:Injection
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 15536)

Indication: Severe established osteoporosis
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 2 # of repeats: 2 DPMQ: $346.48 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Ritosa