Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, PLAIN

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
10958RMP	EVOLOCUMAB evolocumab 140 mg/mL injection, 1 mL pen device (PI, CMI)	3	3	5	$504.66	$31.60	$31.60
	Available brands
	Repatha

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, PLAIN

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
11193DMP	EVOLOCUMAB evolocumab 420 mg/3.5 mL injection, 3.5 mL cartridge (PI, CMI)	1	1	5	$366.68	$31.60	$31.60
	Available brands
	Repatha

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, PLAIN

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
11484KMP	EVOLOCUMAB evolocumab 140 mg/mL injection, 1 mL pen device (PI, CMI)	2	2	5	$339.25	$31.60	$31.60
	Available brands
	Repatha

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, PLAIN

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
11485LMP	EVOLOCUMAB evolocumab 420 mg/3.5 mL injection, 3.5 mL cartridge (PI, CMI)	1	1	5	$366.68	$31.60	$31.60
	Available brands
	Repatha

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, PLAIN

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
11972DMP	EVOLOCUMAB evolocumab 420 mg/3.5 mL injection, 3.5 mL cartridge (PI, CMI)	1	1	5	$366.68	$31.60	$31.60
	Available brands
	Repatha

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, PLAIN

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
11977JMP	EVOLOCUMAB evolocumab 140 mg/mL injection, 1 mL pen device (PI, CMI)	3	3	5	$504.66	$31.60	$31.60
	Available brands
	Repatha

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, PLAIN

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
11985TMP	EVOLOCUMAB evolocumab 140 mg/mL injection, 1 mL pen device (PI, CMI)	2	2	5	$339.25	$31.60	$31.60
	Available brands
	Repatha

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, PLAIN

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
11986WMP	EVOLOCUMAB evolocumab 420 mg/3.5 mL injection, 3.5 mL cartridge (PI, CMI)	1	1	5	$366.68	$31.60	$31.60
	Available brands
	Repatha