SELEXIPAG
| Source | S100 HSD Public |
| Body System | CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES |
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| 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 |
SELEXIPAG
| Source | S100 HSD Public |
| Body System | CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES |
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| 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 |
SELEXIPAG
| Source | S100 HSD Private |
| Body System | CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES |
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| 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 |
SELEXIPAG
| Source | S100 HSD Private |
| Body System | CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES |
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| 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 |
SELEXIPAG
| Source | S100 HSD Private |
| Body System | CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES |
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| 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 |
SELEXIPAG
| Source | S100 HSD Private |
| Body System | CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES |
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| 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 |
SELEXIPAG
| Source | S100 HSD Public |
| Body System | CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES |
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| 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 |
SELEXIPAG
| Source | S100 HSD Private |
| Body System | CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES |
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| 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 |
SELEXIPAG
| Source | S100 HSD Public |
| Body System | CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES |
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| 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 |
SELEXIPAG
| Source | S100 HSD Private |
| Body System | CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES |
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| 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 |
SELEXIPAG
| Source | S100 HSD Public |
| Body System | CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES |
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| 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 |
SELEXIPAG
| Source | S100 HSD Private |
| Body System | CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES |
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| 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 |
SELEXIPAG
| Source | S100 HSD Private |
| Body System | CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES |
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| 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 |
SELEXIPAG
| Source | S100 HSD Public |
| Body System | CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES |
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|
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| 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 |
SELEXIPAG
| Source | S100 HSD Public |
| Body System | CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES |
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|
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| 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 |
SELEXIPAG
| Source | S100 HSD Private |
| Body System | CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES |
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| 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 |
SELEXIPAG
| Source | S100 HSD Public |
| Body System | CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES |
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|
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| 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 |
SELEXIPAG
| Source | S100 HSD Private |
| Body System | CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES |
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|
|
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| 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 |
SELEXIPAG
| Source | S100 HSD Public |
| Body System | CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES |
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| 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 |
SELEXIPAG
| Source | S100 HSD Public |
| Body System | CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES |
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|
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| 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 |
- Legend
- MPMedical Practitioner
