Source	General Schedule
Body System	GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS

Note

Restricted Benefit

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
13300BMP	CHORIOGONADOTROPIN ALFA choriogonadotropin alfa 250 microgram/0.5 mL injection, 0.5 mL pen device (PI, CMI)	4	4	5	$220.03	$31.60	$31.60
	Available brands
	Ovidrela

Source	General Schedule
Body System	GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS

Note

Restricted Benefit

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
14640MMP	CHORIOGONADOTROPIN ALFA choriogonadotropin alfa 250 microgram/0.5 mL injection, 0.5 mL syringe (PI, CMI)	4	4	5	$517.83	$31.60	$31.60
	Available brands
	Ovidrel (USA)a

Source	S100 IVF
Body System	GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS

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
14656JMP	CHORIOGONADOTROPIN ALFA choriogonadotropin alfa 250 microgram/0.5 mL injection, 0.5 mL syringe (PI, CMI)	1	1	0	$125.98	$31.60	$31.60
	Available brands
	Ovidrel (USA)a

Source	S100 IVF
Body System	GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS

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
6182JMP	CHORIOGONADOTROPIN ALFA choriogonadotropin alfa 250 microgram/0.5 mL injection, 0.5 mL pen device (PI, CMI)	1	1	0	$59.52	$31.60	$31.60
	Available brands
	Ovidrela