Source	General Schedule
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTITHROMBOTIC AGENTS > ANTITHROMBOTIC AGENTS

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
11633GMPNP	RIVAROXABAN rivaroxaban 10 mg tablet, 30 (PI, CMI)	1	30	5	$53.50	$31.60	$31.60
	Available brands
	Rivaroxaban-Tevaa
	Xareltoa
	iXarolaa

Source	General Schedule
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTITHROMBOTIC AGENTS > ANTITHROMBOTIC AGENTS

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
12192QMPNP	RIVAROXABAN rivaroxaban 2.5 mg tablet, 60 (PI, CMI)	1	60	5	$48.80	$31.60	$31.60
	Available brands
	Rivaroxaban-Tevaa
	Xareltoa

Source	General Schedule
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTITHROMBOTIC AGENTS > ANTITHROMBOTIC AGENTS

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
12197YMP	RIVAROXABAN rivaroxaban 2.5 mg tablet, 60 (PI, CMI)	1	60	5	$48.80	$31.60	$31.60
	Available brands
	Rivaroxaban-Tevaa
	Xareltoa

Source	General Schedule
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTITHROMBOTIC AGENTS > ANTITHROMBOTIC AGENTS

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
13366LMPNP	RIVAROXABAN rivaroxaban 2.5 mg tablet, 60 (PI, CMI)	2	120	5	$84.15	$31.60	$31.60
	Available brands
	Rivaroxaban-Tevaa
	Xareltoa

Source	General Schedule
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTITHROMBOTIC AGENTS > ANTITHROMBOTIC AGENTS

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
13462MMPNP	RIVAROXABAN rivaroxaban 20 mg tablet, 28 (PI, CMI)	2	56	5	$83.09	$31.60	$31.60
	Available brands
	Rivaroxaban-Tevaa
	Xareltoa
	iXarolaa

Source	General Schedule
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTITHROMBOTIC AGENTS > ANTITHROMBOTIC AGENTS

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
13463NMPNP	RIVAROXABAN rivaroxaban 15 mg tablet, 28 (PI, CMI)	2	56	5	$83.97	$31.60	$31.60
	Available brands
	Rivaroxaban-Tevaa
	Xareltoa
	iXarolaa

Source	General Schedule
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTITHROMBOTIC AGENTS > ANTITHROMBOTIC AGENTS

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
13521PMPNP	RIVAROXABAN rivaroxaban 10 mg tablet, 30 (PI, CMI)	2	60	5	$93.55	$31.60	$31.60
	Available brands
	Rivaroxaban-Tevaa
	Xareltoa
	iXarolaa

Source	General Schedule
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTITHROMBOTIC AGENTS > ANTITHROMBOTIC AGENTS

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
2160QMPNP	RIVAROXABAN rivaroxaban 15 mg tablet, 42 (PI, CMI)	1	42	0	$66.33	$31.60	$31.60
	Available brands
	Rivaroxaban-Tevaa
	Xareltoa

Source	General Schedule
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTITHROMBOTIC AGENTS > ANTITHROMBOTIC AGENTS

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
2268JMPNP	RIVAROXABAN rivaroxaban 20 mg tablet, 28 (PI, CMI)	1	28	5	$48.27	$31.60	$31.60
	Available brands
	Rivaroxaban-Tevaa
	Xareltoa
	iXarolaa

Source	General Schedule
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTITHROMBOTIC AGENTS > ANTITHROMBOTIC AGENTS

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
2691PMPNP	RIVAROXABAN rivaroxaban 15 mg tablet, 28 (PI, CMI)	1	28	5	$48.71	$31.60	$31.60
	Available brands
	Rivaroxaban-Tevaa
	Xareltoa
	iXarolaa

Source	General Schedule
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTITHROMBOTIC AGENTS > ANTITHROMBOTIC AGENTS

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
9466FMPNP	RIVAROXABAN rivaroxaban 10 mg tablet, 15 (PI, CMI)	1	15	1	$33.48	$31.60	$31.60
	Available brands
	Xarelto

Source	General Schedule
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTITHROMBOTIC AGENTS > ANTITHROMBOTIC AGENTS

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
9467GMPNP	RIVAROXABAN rivaroxaban 10 mg tablet, 30 (PI, CMI)	1	30	0	$53.50	$31.60	$31.60
	Available brands
	Rivaroxaban-Tevaa
	Xareltoa
	iXarolaa

Source	General Schedule
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTITHROMBOTIC AGENTS > ANTITHROMBOTIC AGENTS

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
9469JMPNP	RIVAROXABAN rivaroxaban 10 mg tablet, 15 (PI, CMI)	1	15	0	$33.48	$31.60	$31.60
	Available brands
	Xarelto