Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS

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
10138NMP	RANIBIZUMAB ranibizumab 1.65 mg/0.165 mL injection, 0.165 mL syringe (PI, CMI)	1	1	2	$786.36	$31.60	$31.60
	Available brands
	Lucentisa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS

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
10373YMP	RANIBIZUMAB ranibizumab 2.3 mg/0.23 mL injection, 0.23 mL vial (PI, CMI)	1	1	5	$786.36	$31.60	$31.60
	Available brands
	Lucentisa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS

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
10374BMP	RANIBIZUMAB ranibizumab 1.65 mg/0.165 mL injection, 0.165 mL syringe (PI, CMI)	1	1	5	$786.36	$31.60	$31.60
	Available brands
	Lucentisa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS

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
10505XMP	AFLIBERCEPT aflibercept 4 mg/0.1 mL injection, 0.1 mL vial (PI, CMI)	1	1	5	$890.64	$31.60	$31.60
	Available brands
	Eyleaa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > ANTIINFLAMMATORY AGENTS

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
11469PMP	DEXAMETHASONE dexamethasone 700 microgram implant, 1 (PI, CMI)	1	1	1	$1211.74	$31.60	$31.60
	Available brands
	Ozurdex

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS

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
11471RMP	RANIBIZUMAB ranibizumab 2.3 mg/0.23 mL injection, 0.23 mL vial (PI, CMI)	1	1	2	$786.36	$31.60	$31.60
	Available brands
	Lucentisa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS

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
11480FMP	RANIBIZUMAB ranibizumab 1.65 mg/0.165 mL injection, 0.165 mL syringe (PI, CMI)	1	1	2	$786.36	$31.60	$31.60
	Available brands
	Lucentisa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS

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
11975GMP	RANIBIZUMAB ranibizumab 1.65 mg/0.165 mL injection, 0.165 mL syringe (PI, CMI)	1	1	2	$786.36	$31.60	$31.60
	Available brands
	Lucentisa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS

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
11981NMP	RANIBIZUMAB ranibizumab 2.3 mg/0.23 mL injection, 0.23 mL vial (PI, CMI)	1	1	2	$786.36	$31.60	$31.60
	Available brands
	Lucentisa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS

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
11991DMP	AFLIBERCEPT aflibercept 4 mg/0.1 mL injection, 0.1 mL vial (PI, CMI)	1	1	2	$890.64	$31.60	$31.60
	Available brands
	Eyleaa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS

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
12131LMP	AFLIBERCEPT aflibercept 4 mg/0.1 mL injection, 0.1 mL vial (PI, CMI)	1	1	2	$890.64	$31.60	$31.60
	Available brands
	Eyleaa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS

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
12132MMP	AFLIBERCEPT aflibercept 3.6 mg/0.09 mL injection, 0.09 mL syringe (PI, CMI)	1	1	2	$890.64	$31.60	$31.60
	Available brands
	Eyleaa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS

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
12141BMP	AFLIBERCEPT aflibercept 3.6 mg/0.09 mL injection, 0.09 mL syringe (PI, CMI)	1	1	2	$890.64	$31.60	$31.60
	Available brands
	Eyleaa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS

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
12152NMP	AFLIBERCEPT aflibercept 3.6 mg/0.09 mL injection, 0.09 mL syringe (PI, CMI)	1	1	2	$890.64	$31.60	$31.60
	Available brands
	Eyleaa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS

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
12153PMP	AFLIBERCEPT aflibercept 3.6 mg/0.09 mL injection, 0.09 mL syringe (PI, CMI)	1	1	5	$890.64	$31.60	$31.60
	Available brands
	Eyleaa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER 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
13134GMP	RANIBIZUMAB ranibizumab 1.65 mg/0.165 mL injection, 0.165 mL syringe (PI, CMI)	1	1	5	$786.36	$31.60	$31.60
	Available brands
	Lucentisa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER 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
13137KMP	RANIBIZUMAB ranibizumab 2.3 mg/0.23 mL injection, 0.23 mL vial (PI, CMI)	1	1	2	$786.36	$31.60	$31.60
	Available brands
	Lucentisa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER 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
13139MMP	AFLIBERCEPT aflibercept 3.6 mg/0.09 mL injection, 0.09 mL syringe (PI, CMI)	1	1	2	$890.64	$31.60	$31.60
	Available brands
	Eyleaa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER 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
13143RMP	RANIBIZUMAB ranibizumab 1.65 mg/0.165 mL injection, 0.165 mL syringe (PI, CMI)	1	1	2	$786.36	$31.60	$31.60
	Available brands
	Lucentisa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER 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
13146XMP	AFLIBERCEPT aflibercept 4 mg/0.1 mL injection, 0.1 mL vial (PI, CMI)	1	1	2	$890.64	$31.60	$31.60
	Available brands
	Eyleaa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER 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
13149CMP	RANIBIZUMAB ranibizumab 2.3 mg/0.23 mL injection, 0.23 mL vial (PI, CMI)	1	1	2	$786.36	$31.60	$31.60
	Available brands
	Lucentisa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER 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
13150DMP	AFLIBERCEPT aflibercept 3.6 mg/0.09 mL injection, 0.09 mL syringe (PI, CMI)	1	1	5	$890.64	$31.60	$31.60
	Available brands
	Eyleaa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER 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
13151EMP	AFLIBERCEPT aflibercept 4 mg/0.1 mL injection, 0.1 mL vial (PI, CMI)	1	1	2	$890.64	$31.60	$31.60
	Available brands
	Eyleaa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER 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
13156KMP	RANIBIZUMAB ranibizumab 2.3 mg/0.23 mL injection, 0.23 mL vial (PI, CMI)	1	1	2	$786.36	$31.60	$31.60
	Available brands
	Lucentisa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER 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
13157LMP	RANIBIZUMAB ranibizumab 1.65 mg/0.165 mL injection, 0.165 mL syringe (PI, CMI)	1	1	2	$786.36	$31.60	$31.60
	Available brands
	Lucentisa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER 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
13164WMP	AFLIBERCEPT aflibercept 4 mg/0.1 mL injection, 0.1 mL vial (PI, CMI)	1	1	5	$890.64	$31.60	$31.60
	Available brands
	Eyleaa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER 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
13165XMP	RANIBIZUMAB ranibizumab 2.3 mg/0.23 mL injection, 0.23 mL vial (PI, CMI)	1	1	5	$786.36	$31.60	$31.60
	Available brands
	Lucentisa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER 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
13167BMP	AFLIBERCEPT aflibercept 3.6 mg/0.09 mL injection, 0.09 mL syringe (PI, CMI)	1	1	2	$890.64	$31.60	$31.60
	Available brands
	Eyleaa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > ANTIINFLAMMATORY 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
13168CMP	DEXAMETHASONE dexamethasone 700 microgram implant, 1 (PI, CMI)	1	1	1	$1211.74	$31.60	$31.60
	Available brands
	Ozurdex

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS

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
1382RMP	RANIBIZUMAB ranibizumab 2.3 mg/0.23 mL injection, 0.23 mL vial (PI, CMI)	1	1	2	$786.36	$31.60	$31.60
	Available brands
	Lucentisa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER 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
14594DMP	AFLIBERCEPT aflibercept 8 mg/0.07 mL injection, 0.07 mL vial (PI, CMI)	1	1	2	$934.08	$31.60	$31.60
	Available brands
	Eylea

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS

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
14626TMP	AFLIBERCEPT aflibercept 8 mg/0.07 mL injection, 0.07 mL vial (PI, CMI)	1	1	2	$934.08	$31.60	$31.60
	Available brands
	Eylea

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER 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
14627WMP	AFLIBERCEPT aflibercept 8 mg/0.07 mL injection, 0.07 mL vial (PI, CMI)	1	1	5	$934.08	$31.60	$31.60
	Available brands
	Eylea

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS

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
14635GMP	AFLIBERCEPT aflibercept 8 mg/0.07 mL injection, 0.07 mL vial (PI, CMI)	1	1	5	$934.08	$31.60	$31.60
	Available brands
	Eylea

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > OCULAR VASCULAR DISORDER AGENTS

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
2168DMP	AFLIBERCEPT aflibercept 4 mg/0.1 mL injection, 0.1 mL vial (PI, CMI)	1	1	2	$890.64	$31.60	$31.60
	Available brands
	Eyleaa