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
10859MMP	TACROLIMUS tacrolimus 750 microgram capsule, 100 (PI, CMI)	2	200	5	$196.16	$31.60	$31.60
	Available brands
	Tacrolimus Sandoz

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
10860NMP	TACROLIMUS tacrolimus 2 mg capsule, 100 (PI, CMI)	2	200	5	$575.62	$31.60	$31.60
	Available brands
	Tacrolimus Sandoz

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
10870DMP	TACROLIMUS tacrolimus 750 microgram capsule, 100 (PI, CMI)	1	100	3	$119.19	$31.60	$31.60
	Available brands
	Tacrolimus Sandoz

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
10871EMP	TACROLIMUS tacrolimus 2 mg capsule, 100 (PI, CMI)	1	100	3	$333.38	$31.60	$31.60
	Available brands
	Tacrolimus Sandoz

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
10875JMP	TACROLIMUS tacrolimus 750 microgram capsule, 100 (PI, CMI)	2	200	5	$212.67	$31.60	$31.60
	Available brands
	Tacrolimus Sandoz

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
10879NMP	TACROLIMUS tacrolimus 2 mg capsule, 100 (PI, CMI)	2	200	5	$607.31	$31.60	$31.60
	Available brands
	Tacrolimus Sandoz

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
11907QMP	TACROLIMUS tacrolimus 3 mg modified release capsule, 50 (PI, CMI)	2	100	3	$658.20	$31.60	$31.60
	Available brands
	ADVAGRAF XLa
	Tacrolimus XR Sandoza

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
11914CMP	TACROLIMUS tacrolimus 3 mg modified release capsule, 50 (PI, CMI)	1	50	2	$380.00	$31.60	$31.60
	Available brands
	ADVAGRAF XLa
	Tacrolimus XR Sandoza

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
11920JMP	TACROLIMUS tacrolimus 3 mg modified release capsule, 50 (PI, CMI)	2	100	3	$693.19	$31.60	$31.60
	Available brands
	ADVAGRAF XLa
	Tacrolimus XR Sandoza

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
13907YMP	TACROLIMUS tacrolimus 500 microgram modified release capsule, 30 (PI, CMI)	2	60	3	$94.15	$31.60	$31.60
	Available brands
	ADVAGRAF XLa
	Tacrolimus XR Sandoza

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
13908BMP	TACROLIMUS tacrolimus 500 microgram capsule, 100 (PI, CMI)	2	200	3	$151.03	$31.60	$31.60
	Available brands
	Pacrolima
	Pharmacor Tacrolimus 0.5a
	Prografa
	Tacrografa
	Tacrolimus Sandoza

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
13909CMP	TACROLIMUS tacrolimus 5 mg capsule, 50 (PI, CMI)	2	100	3	$720.99	$31.60	$31.60
	Available brands
	Pharmacor Tacrolimus 5a
	Prografa
	Tacrografa
	Tacrolimus Sandoza

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
13962WMP	TACROLIMUS tacrolimus 1 mg modified release capsule, 60 (PI, CMI)	2	120	3	$179.57	$31.60	$31.60
	Available brands
	ADVAGRAF XLa
	Tacrolimus XR Sandoza

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
13995NMP	TACROLIMUS tacrolimus 2 mg capsule, 100 (PI, CMI)	2	200	3	$658.31	$31.60	$31.60
	Available brands
	Tacrolimus Sandoz

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
13996PMP	TACROLIMUS tacrolimus 3 mg modified release capsule, 50 (PI, CMI)	2	100	2	$751.55	$31.60	$31.60
	Available brands
	ADVAGRAF XLa
	Tacrolimus XR Sandoza

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
14039XMP	TACROLIMUS tacrolimus 5 mg modified release capsule, 30 (PI, CMI)	2	60	3	$853.27	$31.60	$31.60
	Available brands
	ADVAGRAF XLa
	Tacrolimus XR Sandoza

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
14066HMP	TACROLIMUS tacrolimus 750 microgram capsule, 100 (PI, CMI)	2	200	3	$229.93	$31.60	$31.60
	Available brands
	Tacrolimus Sandoz

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
14070MMP	TACROLIMUS tacrolimus 1 mg capsule, 100 (PI, CMI)	2	200	3	$293.61	$31.60	$31.60
	Available brands
	Pacrolima
	Pharmacor Tacrolimus 1a
	Prografa
	Tacrografa
	Tacrolimus Sandoza

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
5299XMP	TACROLIMUS tacrolimus 500 microgram modified release capsule, 30 (PI, CMI)	1	30	3	$53.80	$31.60	$31.60
	Available brands
	ADVAGRAF XLa
	Tacrolimus XR Sandoza

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
5300YMP	TACROLIMUS tacrolimus 1 mg modified release capsule, 60 (PI, CMI)	1	60	3	$94.94	$31.60	$31.60
	Available brands
	ADVAGRAF XLa
	Tacrolimus XR Sandoza

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
5451XMP	TACROLIMUS tacrolimus 5 mg modified release capsule, 30 (PI, CMI)	1	30	3	$430.86	$31.60	$31.60
	Available brands
	ADVAGRAF XLa
	Tacrolimus XR Sandoza

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
6216EMP	TACROLIMUS tacrolimus 1 mg capsule, 100 (PI, CMI)	2	200	5	$271.35	$31.60	$31.60
	Available brands
	Pacrolima
	Pharmacor Tacrolimus 1a
	Prografa
	Tacrografa
	Tacrolimus Sandoza

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
6217FMP	TACROLIMUS tacrolimus 5 mg capsule, 50 (PI, CMI)	2	100	5	$665.05	$31.60	$31.60
	Available brands
	Pharmacor Tacrolimus 5a
	Prografa
	Tacrografa
	Tacrolimus Sandoza

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
6328CMP	TACROLIMUS tacrolimus 500 microgram capsule, 100 (PI, CMI)	2	200	5	$140.01	$31.60	$31.60
	Available brands
	Pacrolima
	Pharmacor Tacrolimus 0.5a
	Prografa
	Tacrografa
	Tacrolimus Sandoza

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
8646CMP	TACROLIMUS tacrolimus 500 microgram capsule, 100 (PI, CMI)	1	100	3	$81.35	$31.60	$31.60
	Available brands
	Pacrolima
	Pharmacor Tacrolimus 0.5a
	Prografa
	Tacrografa
	Tacrolimus Sandoza

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
8647DMP	TACROLIMUS tacrolimus 1 mg capsule, 100 (PI, CMI)	1	100	3	$151.04	$31.60	$31.60
	Available brands
	Pacrolima
	Pharmacor Tacrolimus 1a
	Prografa
	Tacrografa
	Tacrolimus Sandoza

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
8648EMP	TACROLIMUS tacrolimus 5 mg capsule, 50 (PI, CMI)	1	50	3	$364.73	$31.60	$31.60
	Available brands
	Pharmacor Tacrolimus 5a
	Prografa
	Tacrografa
	Tacrolimus Sandoza

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
9558CMP	TACROLIMUS tacrolimus 500 microgram capsule, 100 (PI, CMI)	2	200	5	$126.28	$31.60	$31.60
	Available brands
	Pacrolima
	Pharmacor Tacrolimus 0.5a
	Prografa
	Tacrografa
	Tacrolimus Sandoza

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
9560EMP	TACROLIMUS tacrolimus 1 mg capsule, 100 (PI, CMI)	2	200	5	$252.58	$31.60	$31.60
	Available brands
	Pacrolima
	Pharmacor Tacrolimus 1a
	Prografa
	Tacrografa
	Tacrolimus Sandoza

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
9561FMP	TACROLIMUS tacrolimus 5 mg capsule, 50 (PI, CMI)	2	100	5	$631.14	$31.60	$31.60
	Available brands
	Pharmacor Tacrolimus 5a
	Prografa
	Tacrografa
	Tacrolimus Sandoza

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
9664PMP	TACROLIMUS tacrolimus 500 microgram modified release capsule, 30 (PI, CMI)	2	60	5	$75.04	$31.60	$31.60
	Available brands
	ADVAGRAF XLa
	Tacrolimus XR Sandoza

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
9665QMP	TACROLIMUS tacrolimus 1 mg modified release capsule, 60 (PI, CMI)	2	120	5	$151.56	$31.60	$31.60
	Available brands
	ADVAGRAF XLa
	Tacrolimus XR Sandoza

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
9666RMP	TACROLIMUS tacrolimus 5 mg modified release capsule, 30 (PI, CMI)	2	60	5	$750.44	$31.60	$31.60
	Available brands
	ADVAGRAF XLa
	Tacrolimus XR Sandoza

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
9681MMP	TACROLIMUS tacrolimus 500 microgram modified release capsule, 30 (PI, CMI)	2	60	5	$87.71	$31.60	$31.60
	Available brands
	ADVAGRAF XLa
	Tacrolimus XR Sandoza

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
9682NMP	TACROLIMUS tacrolimus 1 mg modified release capsule, 60 (PI, CMI)	2	120	5	$166.29	$31.60	$31.60
	Available brands
	ADVAGRAF XLa
	Tacrolimus XR Sandoza

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
9683PMP	TACROLIMUS tacrolimus 5 mg modified release capsule, 30 (PI, CMI)	2	60	5	$789.13	$31.60	$31.60
	Available brands
	ADVAGRAF XLa
	Tacrolimus XR Sandoza