Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > OTHER RESPIRATORY SYSTEM PRODUCTS > OTHER RESPIRATORY SYSTEM PRODUCTS

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
11463HMP	LUMACAFTOR + IVACAFTOR lumacaftor 200 mg + ivacaftor 125 mg tablet, 112 (PI, CMI)	1	112	5	$17861.17	$31.60	$31.60
	Available brands
	Orkambi

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > OTHER RESPIRATORY SYSTEM PRODUCTS > OTHER RESPIRATORY SYSTEM PRODUCTS

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
11464JMP	LUMACAFTOR + IVACAFTOR lumacaftor 100 mg + ivacaftor 125 mg tablet, 112 (PI, CMI)	1	112	5	$17861.17	$31.60	$31.60
	Available brands
	Orkambi

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > OTHER RESPIRATORY SYSTEM PRODUCTS > OTHER RESPIRATORY SYSTEM PRODUCTS

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
11465KMP	LUMACAFTOR + IVACAFTOR lumacaftor 100 mg + ivacaftor 125 mg tablet, 112 (PI, CMI)	1	112	5	$17812.50	$31.60	$31.60
	Available brands
	Orkambi

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > OTHER RESPIRATORY SYSTEM PRODUCTS > OTHER RESPIRATORY SYSTEM PRODUCTS

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
11466LMP	LUMACAFTOR + IVACAFTOR lumacaftor 200 mg + ivacaftor 125 mg tablet, 112 (PI, CMI)	1	112	5	$17812.50	$31.60	$31.60
	Available brands
	Orkambi

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > OTHER RESPIRATORY SYSTEM PRODUCTS > OTHER RESPIRATORY SYSTEM PRODUCTS

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
11841FMP	LUMACAFTOR + IVACAFTOR lumacaftor 100 mg + ivacaftor 125 mg granules, 56 sachets (PI, CMI)	1	56	5	$17861.17	$31.60	$31.60
	Available brands
	Orkambi

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > OTHER RESPIRATORY SYSTEM PRODUCTS > OTHER RESPIRATORY SYSTEM PRODUCTS

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
11848NMP	LUMACAFTOR + IVACAFTOR lumacaftor 150 mg + ivacaftor 188 mg granules, 56 sachets (PI, CMI)	1	56	5	$17861.17	$31.60	$31.60
	Available brands
	Orkambi

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > OTHER RESPIRATORY SYSTEM PRODUCTS > OTHER RESPIRATORY SYSTEM PRODUCTS

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
11851RMP	LUMACAFTOR + IVACAFTOR lumacaftor 150 mg + ivacaftor 188 mg granules, 56 sachets (PI, CMI)	1	56	5	$17812.50	$31.60	$31.60
	Available brands
	Orkambi

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > OTHER RESPIRATORY SYSTEM PRODUCTS > OTHER RESPIRATORY SYSTEM PRODUCTS

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
11866MMP	LUMACAFTOR + IVACAFTOR lumacaftor 100 mg + ivacaftor 125 mg granules, 56 sachets (PI, CMI)	1	56	5	$17812.50	$31.60	$31.60
	Available brands
	Orkambi

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > OTHER RESPIRATORY SYSTEM PRODUCTS > OTHER RESPIRATORY SYSTEM PRODUCTS

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
13795CMP	LUMACAFTOR + IVACAFTOR lumacaftor 75 mg + ivacaftor 94 mg granules, 56 sachets (PI, CMI)	1	56	5	$17861.17	$31.60	$31.60
	Available brands
	Orkambi

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > OTHER RESPIRATORY SYSTEM PRODUCTS > OTHER RESPIRATORY SYSTEM PRODUCTS

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
13798FMP	LUMACAFTOR + IVACAFTOR lumacaftor 75 mg + ivacaftor 94 mg granules, 56 sachets (PI, CMI)	1	56	5	$17812.50	$31.60	$31.60
	Available brands
	Orkambi