Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
10111EMP	EPOPROSTENOL epoprostenol 500 microgram injection, 1 vial (PI, CMI)	30	30	5	$1046.97	$31.60	$31.60
	Available brands
	Veletria

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
10117LMP	EPOPROSTENOL epoprostenol 1.5 mg injection, 1 vial (PI, CMI)	30	30	5	$1779.90	$31.60	$31.60
	Available brands
	Veletria

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
10129DMP	EPOPROSTENOL epoprostenol 1.5 mg injection, 1 vial (PI, CMI)	30	30	5	$1828.47	$31.60	$31.60
	Available brands
	Veletria

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
10130EMP	EPOPROSTENOL epoprostenol 500 microgram injection, 1 vial (PI, CMI)	30	30	5	$998.40	$31.60	$31.60
	Available brands
	Veletria

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
10134JMP	MACITENTAN macitentan 10 mg tablet, 30 (PI, CMI)	1	30	5	$2781.32	$31.60	$31.60
	Available brands
	Opsumit

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
10136LMP	MACITENTAN macitentan 10 mg tablet, 30 (PI, CMI)	1	30	5	$2732.65	$31.60	$31.60
	Available brands
	Opsumit

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
11028KMP	RIOCIGUAT riociguat 1 mg tablet, 42 (PI, CMI)	1	42	0	$1680.49	$31.60	$31.60
	Available brands
	Adempas

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
11031NMP	RIOCIGUAT riociguat 500 microgram tablet, 42 (PI, CMI)	1	42	0	$1680.49	$31.60	$31.60
	Available brands
	Adempas

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
11038YMP	RIOCIGUAT riociguat 2 mg tablet, 42 (PI, CMI)	1	42	0	$1631.82	$31.60	$31.60
	Available brands
	Adempas

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
11040CMP	RIOCIGUAT riociguat 500 microgram tablet, 42 (PI, CMI)	1	42	0	$1631.82	$31.60	$31.60
	Available brands
	Adempas

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
11045HMP	RIOCIGUAT riociguat 2 mg tablet, 42 (PI, CMI)	1	42	0	$1680.49	$31.60	$31.60
	Available brands
	Adempas

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
11046JMP	RIOCIGUAT riociguat 1.5 mg tablet, 42 (PI, CMI)	1	42	0	$1680.49	$31.60	$31.60
	Available brands
	Adempas

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
11047KMP	RIOCIGUAT riociguat 1.5 mg tablet, 42 (PI, CMI)	1	42	0	$1631.82	$31.60	$31.60
	Available brands
	Adempas

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
11052QMP	RIOCIGUAT riociguat 2.5 mg tablet, 42 (PI, CMI)	1	42	0	$1680.49	$31.60	$31.60
	Available brands
	Adempas

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
11054TMP	RIOCIGUAT riociguat 1 mg tablet, 42 (PI, CMI)	1	42	0	$1631.82	$31.60	$31.60
	Available brands
	Adempas

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
11057YMP	RIOCIGUAT riociguat 2.5 mg tablet, 42 (PI, CMI)	1	42	0	$1631.82	$31.60	$31.60
	Available brands
	Adempas

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
11065JMP	EPOPROSTENOL epoprostenol 1.5 mg injection [1 vial] (&) inert substance diluent [2 x 50 mL vials], 1 pack (PI, CMI)	30	30	5	$1779.90	$31.60	$31.60
	Available brands
	Flolana

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
11069NMP	EPOPROSTENOL epoprostenol 500 microgram injection [1 vial] (&) inert substance diluent [2 x 50 mL vials], 1 pack (PI, CMI)	30	30	5	$934.47	$31.60	$31.60
	Available brands
	Flolana

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
11082GMP	EPOPROSTENOL epoprostenol 1.5 mg injection [1 vial] (&) inert substance diluent [2 x 50 mL vials], 1 pack (PI, CMI)	30	30	5	$1828.47	$31.60	$31.60
	Available brands
	Flolana

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
11090QMP	EPOPROSTENOL epoprostenol 500 microgram injection [1 vial] (&) inert substance diluent [2 x 50 mL vials], 1 pack (PI, CMI)	30	30	5	$890.10	$31.60	$31.60
	Available brands
	Flolana

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
12134PMP	BOSENTAN bosentan 62.5 mg tablet, 60 (PI, CMI)	1	60	5	$169.30	$31.60	$31.60
	Available brands
	BOSENTAN DR.REDDY'Sa
	BOSLEERa
	Bosentan APOa
	Bosentan Mylana
	Bosentan RBXa

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
12135QMP	MACITENTAN macitentan 10 mg tablet, 30 (PI, CMI)	1	30	5	$2781.32	$31.60	$31.60
	Available brands
	Opsumit

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12138WMP	SILDENAFIL sildenafil 20 mg tablet, 90 (PI, CMI)	1	90	5	$145.22	$31.60	$31.60
	Available brands
	Revatioa
	SILDATIO PHTa
	Sildenafil PHT APOTEXa
	Sildenafil Sandoz PHT 20a

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
12139XMP	BOSENTAN bosentan 62.5 mg tablet, 60 (PI, CMI)	1	60	5	$184.74	$31.60	$31.60
	Available brands
	BOSENTAN DR.REDDY'Sa
	BOSLEERa
	Bosentan APOa
	Bosentan Mylana
	Bosentan RBXa

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
12140YMP	BOSENTAN bosentan 62.5 mg tablet, 60 (PI, CMI)	1	60	0	$169.30	$31.60	$31.60
	Available brands
	BOSENTAN DR.REDDY'Sa
	BOSLEERa
	Bosentan APOa
	Bosentan Mylana
	Bosentan RBXa

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
12143DMP	BOSENTAN bosentan 62.5 mg tablet, 60 (PI, CMI)	1	60	0	$184.74	$31.60	$31.60
	Available brands
	BOSENTAN DR.REDDY'Sa
	BOSLEERa
	Bosentan APOa
	Bosentan Mylana
	Bosentan RBXa

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12144EMP	SILDENAFIL sildenafil 20 mg tablet, 90 (PI, CMI)	1	90	5	$131.30	$31.60	$31.60
	Available brands
	Revatioa
	SILDATIO PHTa
	Sildenafil PHT APOTEXa
	Sildenafil Sandoz PHT 20a

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
12145FMP	BOSENTAN bosentan 62.5 mg tablet, 60 (PI, CMI)	1	60	5	$169.30	$31.60	$31.60
	Available brands
	BOSENTAN DR.REDDY'Sa
	BOSLEERa
	Bosentan APOa
	Bosentan Mylana
	Bosentan RBXa

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
12146GMP	BOSENTAN bosentan 125 mg tablet, 60 (PI, CMI)	1	60	5	$184.74	$31.60	$31.60
	Available brands
	BOSENTAN DR.REDDY'Sa
	BOSLEERa
	Bosentan APOa
	Bosentan GHa
	Bosentan Mylana
	Bosentan RBXa

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
12147HMP	MACITENTAN macitentan 10 mg tablet, 30 (PI, CMI)	1	30	5	$2732.65	$31.60	$31.60
	Available brands
	Opsumit

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
12148JMP	BOSENTAN bosentan 62.5 mg tablet, 60 (PI, CMI)	1	60	5	$184.74	$31.60	$31.60
	Available brands
	BOSENTAN DR.REDDY'Sa
	BOSLEERa
	Bosentan APOa
	Bosentan Mylana
	Bosentan RBXa

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
12149KMP	BOSENTAN bosentan 125 mg tablet, 60 (PI, CMI)	1	60	5	$169.30	$31.60	$31.60
	Available brands
	BOSENTAN DR.REDDY'Sa
	BOSLEERa
	Bosentan APOa
	Bosentan GHa
	Bosentan Mylana
	Bosentan RBXa

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12150LMP	TADALAFIL tadalafil 20 mg tablet, 56 (PI, CMI)	1	56	5	$503.23	$31.60	$31.60
	Available brands
	Adcircaa
	TADALIS 20a
	Tadalcaa

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12151MMP	TADALAFIL tadalafil 20 mg tablet, 56 (PI, CMI)	1	56	5	$475.54	$31.60	$31.60
	Available brands
	Adcircaa
	TADALIS 20a
	Tadalcaa

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
12180CMP	AMBRISENTAN ambrisentan 10 mg tablet, 30 (PI, CMI)	1	30	5	$1430.20	$31.60	$31.60
	Available brands
	Ambrisentan Viatrisa
	Cipla Ambrisentana
	PULMORISa
	Volibrisa

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
12186JMP	AMBRISENTAN ambrisentan 10 mg tablet, 30 (PI, CMI)	1	30	5	$1381.53	$31.60	$31.60
	Available brands
	Ambrisentan Viatrisa
	Cipla Ambrisentana
	PULMORISa
	Volibrisa

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
12201EMP	AMBRISENTAN ambrisentan 5 mg tablet, 30 (PI, CMI)	1	30	5	$1430.20	$31.60	$31.60
	Available brands
	Ambrisentan Viatrisa
	Cipla Ambrisentana
	PULMORISa
	Volibrisa

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
12212RMP	AMBRISENTAN ambrisentan 5 mg tablet, 30 (PI, CMI)	1	30	5	$1381.53	$31.60	$31.60
	Available brands
	Ambrisentan Viatrisa
	Cipla Ambrisentana
	PULMORISa
	Volibrisa

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12235YMP	SELEXIPAG selexipag 400 microgram tablet, 60 (PI, CMI)	1	60	5	$3450.00	$31.60	$31.60
	Available brands
	Uptravi

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12240FMP	SELEXIPAG selexipag 1.4 mg tablet, 60 (PI, CMI)	1	60	5	$3450.00	$31.60	$31.60
	Available brands
	Uptravi

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12241GMP	SELEXIPAG selexipag 200 microgram tablet, 140 (PI, CMI)	1	140	2	$8098.67	$31.60	$31.60
	Available brands
	Uptravi

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12242HMP	SELEXIPAG selexipag 200 microgram tablet, 60 (PI, CMI)	1	60	5	$3498.67	$31.60	$31.60
	Available brands
	Uptravi

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12245LMP	SELEXIPAG selexipag 1 mg tablet, 60 (PI, CMI)	1	60	5	$3498.67	$31.60	$31.60
	Available brands
	Uptravi

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12246MMP	SELEXIPAG selexipag 800 microgram tablet, 60 (PI, CMI)	1	60	5	$3498.67	$31.60	$31.60
	Available brands
	Uptravi

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12247NMP	SELEXIPAG selexipag 200 microgram tablet, 60 (PI, CMI)	1	60	5	$3450.00	$31.60	$31.60
	Available brands
	Uptravi

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12248PMP	SELEXIPAG selexipag 600 microgram tablet, 60 (PI, CMI)	1	60	5	$3498.67	$31.60	$31.60
	Available brands
	Uptravi

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12249QMP	SELEXIPAG selexipag 800 microgram tablet, 60 (PI, CMI)	1	60	5	$3450.00	$31.60	$31.60
	Available brands
	Uptravi

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12251TMP	SELEXIPAG selexipag 1.4 mg tablet, 60 (PI, CMI)	1	60	5	$3498.67	$31.60	$31.60
	Available brands
	Uptravi

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12252WMP	SELEXIPAG selexipag 1.2 mg tablet, 60 (PI, CMI)	1	60	5	$3450.00	$31.60	$31.60
	Available brands
	Uptravi

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12253XMP	SELEXIPAG selexipag 800 microgram tablet, 60 (PI, CMI)	1	60	3	$3498.67	$31.60	$31.60
	Available brands
	Uptravi

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12257DMP	SELEXIPAG selexipag 1.2 mg tablet, 60 (PI, CMI)	1	60	5	$3498.67	$31.60	$31.60
	Available brands
	Uptravi

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12258EMP	SELEXIPAG selexipag 200 microgram tablet, 140 (PI, CMI)	1	140	2	$8050.00	$31.60	$31.60
	Available brands
	Uptravi

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12259FMP	SELEXIPAG selexipag 1 mg tablet, 60 (PI, CMI)	1	60	5	$3450.00	$31.60	$31.60
	Available brands
	Uptravi

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12260GMP	SELEXIPAG selexipag 400 microgram tablet, 60 (PI, CMI)	1	60	5	$3498.67	$31.60	$31.60
	Available brands
	Uptravi

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12263KMP	SELEXIPAG selexipag 600 microgram tablet, 60 (PI, CMI)	1	60	5	$3450.00	$31.60	$31.60
	Available brands
	Uptravi

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12264LMP	SELEXIPAG selexipag 1.6 mg tablet, 60 (PI, CMI)	1	60	5	$3498.67	$31.60	$31.60
	Available brands
	Uptravi

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12265MMP	SELEXIPAG selexipag 1.6 mg tablet, 60 (PI, CMI)	1	60	5	$3450.00	$31.60	$31.60
	Available brands
	Uptravi

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12266NMP	SELEXIPAG selexipag 800 microgram tablet, 60 (PI, CMI)	1	60	3	$3450.00	$31.60	$31.60
	Available brands
	Uptravi

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
1304PMP	TADALAFIL tadalafil 20 mg tablet, 56 (PI, CMI)	1	56	5	$503.23	$31.60	$31.60
	Available brands
	Adcircaa
	TADALIS 20a
	Tadalcaa

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
1308WMP	TADALAFIL tadalafil 20 mg tablet, 56 (PI, CMI)	1	56	5	$475.54	$31.60	$31.60
	Available brands
	Adcircaa
	TADALIS 20a
	Tadalcaa

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
14229XMP	TADALAFIL tadalafil 20 mg tablet, 60 (PI, CMI)	1	60	5	$538.56	$31.60	$31.60
	Available brands
	Tadalis 20

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
14240LMP	TADALAFIL tadalafil 20 mg tablet, 60 (PI, CMI)	1	60	5	$538.56	$31.60	$31.60
	Available brands
	Tadalis 20

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
14271DMP	TADALAFIL tadalafil 20 mg tablet, 60 (PI, CMI)	1	60	5	$509.51	$31.60	$31.60
	Available brands
	Tadalis 20

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
14281PMP	TADALAFIL tadalafil 20 mg tablet, 60 (PI, CMI)	1	60	5	$509.51	$31.60	$31.60
	Available brands
	Tadalis 20

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
5607DMP	AMBRISENTAN ambrisentan 5 mg tablet, 30 (PI, CMI)	1	30	5	$1381.53	$31.60	$31.60
	Available brands
	Ambrisentan Viatrisa
	Cipla Ambrisentana
	PULMORISa
	Volibrisa

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
5608EMP	AMBRISENTAN ambrisentan 10 mg tablet, 30 (PI, CMI)	1	30	5	$1381.53	$31.60	$31.60
	Available brands
	Ambrisentan Viatrisa
	Cipla Ambrisentana
	PULMORISa
	Volibrisa

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
5618QMP	BOSENTAN bosentan 62.5 mg tablet, 60 (PI, CMI)	1	60	5	$169.30	$31.60	$31.60
	Available brands
	BOSENTAN DR.REDDY'Sa
	BOSLEERa
	Bosentan APOa
	Bosentan Mylana
	Bosentan RBXa

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
5619RMP	BOSENTAN bosentan 125 mg tablet, 60 (PI, CMI)	1	60	5	$169.30	$31.60	$31.60
	Available brands
	BOSENTAN DR.REDDY'Sa
	BOSLEERa
	Bosentan APOa
	Bosentan GHa
	Bosentan Mylana
	Bosentan RBXa

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
5751QMP	ILOPROST iloprost 20 microgram/2 mL inhalation solution, 30 x 2 mL ampoules (PI, CMI)	1	30	5	$349.59	$31.60	$31.60
	Available brands
	Ventavis

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
6429JMP	BOSENTAN bosentan 62.5 mg tablet, 60 (PI, CMI)	1	60	5	$184.74	$31.60	$31.60
	Available brands
	BOSENTAN DR.REDDY'Sa
	BOSLEERa
	Bosentan APOa
	Bosentan Mylana
	Bosentan RBXa

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
6430KMP	BOSENTAN bosentan 125 mg tablet, 60 (PI, CMI)	1	60	5	$184.74	$31.60	$31.60
	Available brands
	BOSENTAN DR.REDDY'Sa
	BOSLEERa
	Bosentan APOa
	Bosentan GHa
	Bosentan Mylana
	Bosentan RBXa

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
6456TMP	ILOPROST iloprost 20 microgram/2 mL inhalation solution, 30 x 2 mL ampoules (PI, CMI)	1	30	5	$372.24	$31.60	$31.60
	Available brands
	Ventavis

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
9547LMP	SILDENAFIL sildenafil 20 mg tablet, 90 (PI, CMI)	1	90	5	$131.30	$31.60	$31.60
	Available brands
	Revatioa
	SILDATIO PHTa
	Sildenafil PHT APOTEXa
	Sildenafil Sandoz PHT 20a

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
9605MMP	SILDENAFIL sildenafil 20 mg tablet, 90 (PI, CMI)	1	90	5	$145.22	$31.60	$31.60
	Available brands
	Revatioa
	SILDATIO PHTa
	Sildenafil PHT APOTEXa
	Sildenafil Sandoz PHT 20a

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
9648TMP	AMBRISENTAN ambrisentan 5 mg tablet, 30 (PI, CMI)	1	30	5	$1430.20	$31.60	$31.60
	Available brands
	Ambrisentan Viatrisa
	Cipla Ambrisentana
	PULMORISa
	Volibrisa

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

Caution

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
9649WMP	AMBRISENTAN ambrisentan 10 mg tablet, 30 (PI, CMI)	1	30	5	$1430.20	$31.60	$31.60
	Available brands
	Ambrisentan Viatrisa
	Cipla Ambrisentana
	PULMORISa
	Volibrisa