Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

Note

Authority Required

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
10109CMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL syringe (PI, CMI)	1	1	7	$215.19	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

Note

Authority Required

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
10110DMP	OMALIZUMAB omalizumab 75 mg/0.5 mL injection, 0.5 mL syringe (PI, CMI)	1	1	7	$120.57	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

Note

Authority Required

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
10118MMP	OMALIZUMAB omalizumab 75 mg/0.5 mL injection, 0.5 mL syringe (PI, CMI)	1	1	7	$107.60	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

Note

Authority Required

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
10122RMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL syringe (PI, CMI)	1	1	7	$232.47	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

Note

Authority Required

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
10956PMP	OMALIZUMAB omalizumab 75 mg/0.5 mL injection, 0.5 mL syringe (PI, CMI)	1	1	6	$120.57	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

Note

Authority Required

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
10967FMP	OMALIZUMAB omalizumab 75 mg/0.5 mL injection, 0.5 mL syringe (PI, CMI)	1	1	6	$107.60	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

Note

Authority Required

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
10968GMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL syringe (PI, CMI)	1	1	6	$232.47	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

Note

Authority Required

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
10973MMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL syringe (PI, CMI)	1	1	6	$215.19	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Private
Body System	DERMATOLOGICALS > OTHER DERMATOLOGICAL PREPARATIONS > OTHER DERMATOLOGICAL PREPARATIONS

Note

Authority Required

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
11163MMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL syringe (PI, CMI)	2	2	5	$456.27	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Public
Body System	DERMATOLOGICALS > OTHER DERMATOLOGICAL PREPARATIONS > OTHER DERMATOLOGICAL PREPARATIONS

Note

Authority Required

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
11168TMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL syringe (PI, CMI)	2	2	5	$430.38	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Private
Body System	DERMATOLOGICALS > OTHER DERMATOLOGICAL PREPARATIONS > OTHER DERMATOLOGICAL PREPARATIONS

Note

Authority Required

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
11175EMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL syringe (PI, CMI)	2	2	2	$456.27	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Public
Body System	DERMATOLOGICALS > OTHER DERMATOLOGICAL PREPARATIONS > OTHER DERMATOLOGICAL PREPARATIONS

Note

Authority Required

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
11176FMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL syringe (PI, CMI)	2	2	2	$430.38	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

Note

Authority Required

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
11824HMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL syringe (PI, CMI)	1	1	5	$215.19	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

Note

Authority Required

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
11825JMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL syringe (PI, CMI)	1	1	0	$232.47	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

Note

Authority Required

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
11826KMP	OMALIZUMAB omalizumab 75 mg/0.5 mL injection, 0.5 mL syringe (PI, CMI)	1	1	0	$120.57	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

Note

Authority Required

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
11828MMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL syringe (PI, CMI)	1	1	0	$215.19	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

Note

Authority Required

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
11835XMP	OMALIZUMAB omalizumab 75 mg/0.5 mL injection, 0.5 mL syringe (PI, CMI)	1	1	5	$107.60	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

Note

Authority Required

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
11840EMP	OMALIZUMAB omalizumab 75 mg/0.5 mL injection, 0.5 mL syringe (PI, CMI)	1	1	5	$120.57	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

Note

Authority Required

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
11846LMP	OMALIZUMAB omalizumab 75 mg/0.5 mL injection, 0.5 mL syringe (PI, CMI)	1	1	0	$107.60	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

Note

Authority Required

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
11864KMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL syringe (PI, CMI)	1	1	5	$232.47	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

Note

Authority Required

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
11932BMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL syringe (PI, CMI)	1	1	0	$232.47	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

Note

Authority Required

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
11945QMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL syringe (PI, CMI)	1	1	5	$215.19	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

Note

Authority Required

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
11946RMP	OMALIZUMAB omalizumab 75 mg/0.5 mL injection, 0.5 mL syringe (PI, CMI)	1	1	5	$107.60	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

Note

Authority Required

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
11950YMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL syringe (PI, CMI)	1	1	0	$215.19	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

Note

Authority Required

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
11952CMP	OMALIZUMAB omalizumab 75 mg/0.5 mL injection, 0.5 mL syringe (PI, CMI)	1	1	5	$120.57	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

Note

Authority Required

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
11953DMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL syringe (PI, CMI)	1	1	5	$232.47	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

Note

Authority Required

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
11958JMP	OMALIZUMAB omalizumab 75 mg/0.5 mL injection, 0.5 mL syringe (PI, CMI)	1	1	0	$120.57	$31.60	$31.60
	Available brands
	Xolair

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

Note

Authority Required

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
11962NMP	OMALIZUMAB omalizumab 75 mg/0.5 mL injection, 0.5 mL syringe (PI, CMI)	1	1	0	$107.60	$31.60	$31.60
	Available brands
	Xolair