FOLINIC ACID

FOLINIC ACID (1610R)

folinic acid 50 mg/5 mL injection, 10 x 5 mL ampoules
1610R
Body System:
Manner of administration:Injection
General Schedule
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 10 # of repeats: 2 DPMQ: $228.93 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Leucovorin Calcium (Pfizer Australia Pty Ltd)

FOLINIC ACID (1899Y)

folinic acid 50 mg/5 mL injection, 10 x 5 mL ampoules
1899Y
Body System:
Manner of administration:Injection
Section 100 (CT)
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 10 # of repeats: 2 DPMQ: $195.00 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Leucovorin Calcium (Pfizer Australia Pty Ltd)

FOLINIC ACID (2308L)

folinic acid 15 mg tablet, 10
2308L
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Megaloblastic anaemias
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 10 # of repeats: 0 DPMQ: $95.51 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Leucovorin Calcium (Hospira Pty Limited)

FOLINIC ACID (5890B)

folinic acid 50 mg/5 mL injection, 5 mL vial
5890B
Body System:
Manner of administration:Injection
Section 100 (CT)
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 10 Max qty units: 10 # of repeats: 2 DPMQ: $195.00 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
DBL Leucovorin Calcium

FOLINIC ACID (5904R)

folinic acid 15 mg tablet, 10
5904R
Body System:
Manner of administration:Oral
Section 100 (CT)
Restricted Benefit

Restriction

Indication: Megaloblastic anaemias
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 10 # of repeats: 0 DPMQ: $76.00 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Leucovorin Calcium (Hospira Pty Limited)

FOLINIC ACID (8740B)

folinic acid 50 mg/5 mL injection, 5 mL vial
8740B
Body System:
Manner of administration:Injection
General Schedule
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 10 Max qty units: 10 # of repeats: 2 DPMQ: $228.98 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
DBL Leucovorin Calcium