Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
10131FMP	EVEROLIMUS everolimus 5 mg tablet, 30 (PI, CMI)	1	30	5	$901.84	$31.60	$31.60
	Available brands
	Afinitor

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
10132GMP	EVEROLIMUS everolimus 10 mg tablet, 30 (PI, CMI)	1	30	2	$1738.38	$31.60	$31.60
	Available brands
	Afinitor

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
10133HMP	EVEROLIMUS everolimus 5 mg tablet, 30 (PI, CMI)	1	30	2	$901.84	$31.60	$31.60
	Available brands
	Afinitor

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
10135KMP	EVEROLIMUS everolimus 10 mg tablet, 30 (PI, CMI)	1	30	5	$1738.38	$31.60	$31.60
	Available brands
	Afinitor

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
11254HMP	EVEROLIMUS everolimus 5 mg tablet, 30 (PI, CMI)	1	30	5	$901.84	$31.60	$31.60
	Available brands
	Afinitor

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

Note

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
11257LMP	EVEROLIMUS everolimus 5 mg tablet, 30 (PI, CMI)	1	30	5	$901.84	$31.60	$31.60
	Available brands
	Afinitor

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
11258MMP	EVEROLIMUS everolimus 2.5 mg tablet, 30 (PI, CMI)	1	30	5	$458.19	$31.60	$31.60
	Available brands
	Afinitor

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

Note

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
11262RMP	EVEROLIMUS everolimus 10 mg tablet, 30 (PI, CMI)	1	30	5	$1738.38	$31.60	$31.60
	Available brands
	Afinitor

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
11267BMP	EVEROLIMUS everolimus 10 mg tablet, 30 (PI, CMI)	1	30	5	$1738.38	$31.60	$31.60
	Available brands
	Afinitor

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
11362BMP	EVEROLIMUS everolimus 5 mg tablet, 30 (PI, CMI)	1	30	2	$901.84	$31.60	$31.60
	Available brands
	Afinitor

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
11377TMP	EVEROLIMUS everolimus 10 mg tablet, 30 (PI, CMI)	1	30	2	$1738.38	$31.60	$31.60
	Available brands
	Afinitor

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
11591CMP	EVEROLIMUS everolimus 2 mg dispersible tablet, 30 (PI, CMI)	1	30	5	$368.15	$31.60	$31.60
	Available brands
	Afinitor

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
11592DMP	EVEROLIMUS everolimus 5 mg dispersible tablet, 30 (PI, CMI)	1	30	5	$901.63	$31.60	$31.60
	Available brands
	Afinitor

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

Note

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
11598KMP	EVEROLIMUS everolimus 5 mg dispersible tablet, 30 (PI, CMI)	1	30	5	$901.63	$31.60	$31.60
	Available brands
	Afinitor

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
11599LMP	EVEROLIMUS everolimus 3 mg dispersible tablet, 30 (PI, CMI)	1	30	5	$547.99	$31.60	$31.60
	Available brands
	Afinitor

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

Note

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
11607XMP	EVEROLIMUS everolimus 2 mg dispersible tablet, 30 (PI, CMI)	1	30	5	$368.15	$31.60	$31.60
	Available brands
	Afinitor

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

Note

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
11608YMP	EVEROLIMUS everolimus 3 mg dispersible tablet, 30 (PI, CMI)	1	30	5	$547.99	$31.60	$31.60
	Available brands
	Afinitor

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

Restricted Benefit

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
13941RMP	EVEROLIMUS everolimus 1 mg tablet, 60 (PI, CMI)	4	240	3	$2284.31	$31.60	$31.60
	Available brands
	Certicana
	Everocana

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

Restricted Benefit

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
14040YMP	EVEROLIMUS everolimus 750 microgram tablet, 60 (PI, CMI)	4	240	3	$1736.15	$31.60	$31.60
	Available brands
	Certicana
	Everocana

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
2818HMP	EVEROLIMUS everolimus 2.5 mg tablet, 30 (PI, CMI)	1	30	5	$458.19	$31.60	$31.60
	Available brands
	Afinitor

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
2819JMP	EVEROLIMUS everolimus 5 mg tablet, 30 (PI, CMI)	1	30	5	$901.84	$31.60	$31.60
	Available brands
	Afinitor

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
2985DMP	EVEROLIMUS everolimus 10 mg tablet, 30 (PI, CMI)	1	30	5	$1738.38	$31.60	$31.60
	Available brands
	Afinitor

Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
5737YMP	EVEROLIMUS everolimus 1 mg tablet, 60 (PI, CMI)	4	240	5	$2121.68	$31.60	$31.60
	Available brands
	Certicana
	Everocana

Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
5738BMP	EVEROLIMUS everolimus 250 microgram tablet, 60 (PI, CMI)	2	120	5	$303.86	$31.60	$31.60
	Available brands
	Certicana
	Everocana

Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
5739CMP	EVEROLIMUS everolimus 500 microgram tablet, 60 (PI, CMI)	2	120	5	$530.42	$31.60	$31.60
	Available brands
	Certicana
	Everocana

Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
5740DMP	EVEROLIMUS everolimus 750 microgram tablet, 60 (PI, CMI)	4	240	5	$1591.24	$31.60	$31.60
	Available brands
	Certicana
	Everocana

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
6459YMP	EVEROLIMUS everolimus 250 microgram tablet, 60 (PI, CMI)	2	120	5	$324.69	$31.60	$31.60
	Available brands
	Certicana
	Everocana

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
6460BMP	EVEROLIMUS everolimus 500 microgram tablet, 60 (PI, CMI)	2	120	5	$560.31	$31.60	$31.60
	Available brands
	Certicana
	Everocana

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
6461CMP	EVEROLIMUS everolimus 750 microgram tablet, 60 (PI, CMI)	4	240	5	$1639.91	$31.60	$31.60
	Available brands
	Certicana
	Everocana

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
8840GMP	EVEROLIMUS everolimus 250 microgram tablet, 60 (PI, CMI)	1	60	3	$179.99	$31.60	$31.60
	Available brands
	Certicana
	Everocana

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
8841HMP	EVEROLIMUS everolimus 500 microgram tablet, 60 (PI, CMI)	1	60	3	$307.87	$31.60	$31.60
	Available brands
	Certicana
	Everocana

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
8842JMP	EVEROLIMUS everolimus 750 microgram tablet, 60 (PI, CMI)	2	120	3	$872.29	$31.60	$31.60
	Available brands
	Certicana
	Everocana

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
9352FMP	EVEROLIMUS everolimus 1 mg tablet, 60 (PI, CMI)	2	120	3	$1150.77	$31.60	$31.60
	Available brands
	Certicana
	Everocana

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
9582HMP	EVEROLIMUS everolimus 1 mg tablet, 60 (PI, CMI)	4	240	5	$2170.35	$31.60	$31.60
	Available brands
	Certicana
	Everocana