ELTROMBOPAG

Source S100 HSD Private
Body System BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS
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
14107LMP ELTROMBOPAG
eltrombopag 50 mg tablet, 28 (PI, CMI)
3 84 3 $7417.38 $31.60 $31.60
Available brands
Revolade
space

ELTROMBOPAG

Source S100 HSD Public
Body System BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS
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
14112RMP ELTROMBOPAG
eltrombopag 50 mg tablet, 28 (PI, CMI)
3 84 5 $7368.72 $31.60 $31.60
Available brands
Revolade
space

ELTROMBOPAG

Source S100 HSD Private
Body System BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS
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
14115XMP ELTROMBOPAG
eltrombopag 25 mg tablet, 28 (PI, CMI)
3 84 3 $3733.02 $31.60 $31.60
Available brands
Revolade
space

ELTROMBOPAG

Source S100 HSD Private
Body System BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS
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
14119DMP ELTROMBOPAG
eltrombopag 25 mg tablet, 28 (PI, CMI)
3 84 5 $3733.02 $31.60 $31.60
Available brands
Revolade
space

ELTROMBOPAG

Source S100 HSD Public
Body System BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS
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
14120EMP ELTROMBOPAG
eltrombopag 25 mg tablet, 28 (PI, CMI)
3 84 5 $3684.36 $31.60 $31.60
Available brands
Revolade
space

ELTROMBOPAG

Source S100 HSD Public
Body System BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS
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
14121FMP ELTROMBOPAG
eltrombopag 50 mg tablet, 28 (PI, CMI)
3 84 3 $7368.72 $31.60 $31.60
Available brands
Revolade
space

ELTROMBOPAG

Source S100 HSD Private
Body System BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS
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
14127MMP ELTROMBOPAG
eltrombopag 50 mg tablet, 28 (PI, CMI)
3 84 5 $7417.38 $31.60 $31.60
Available brands
Revolade
space

ELTROMBOPAG

Source S100 HSD Public
Body System BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS
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
14128NMP ELTROMBOPAG
eltrombopag 25 mg tablet, 28 (PI, CMI)
3 84 5 $3684.36 $31.60 $31.60
Available brands
Revolade
space

ELTROMBOPAG

Source S100 HSD Public
Body System BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS
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
14131RMP ELTROMBOPAG
eltrombopag 50 mg tablet, 28 (PI, CMI)
3 84 5 $7368.72 $31.60 $31.60
Available brands
Revolade
space

ELTROMBOPAG

Source S100 HSD Private
Body System BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS
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
14136BMP ELTROMBOPAG
eltrombopag 25 mg tablet, 28 (PI, CMI)
3 84 5 $3733.02 $31.60 $31.60
Available brands
Revolade
space

ELTROMBOPAG

Source S100 HSD Private
Body System BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS
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
14143JMP ELTROMBOPAG
eltrombopag 50 mg tablet, 28 (PI, CMI)
3 84 5 $7417.38 $31.60 $31.60
Available brands
Revolade
space

ELTROMBOPAG

Source S100 HSD Public
Body System BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS
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
14144KMP ELTROMBOPAG
eltrombopag 25 mg tablet, 28 (PI, CMI)
3 84 3 $3684.36 $31.60 $31.60
Available brands
Revolade
space

ELTROMBOPAG

Source S100 HSD Public
Body System BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS
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
5825NMP ELTROMBOPAG
eltrombopag 25 mg tablet, 28 (PI, CMI)
1 28 5 $1228.12 $31.60 $31.60
Available brands
Revolade
space

ELTROMBOPAG

Source S100 HSD Public
Body System BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS
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
5826PMP ELTROMBOPAG
eltrombopag 50 mg tablet, 28 (PI, CMI)
1 28 5 $2456.24 $31.60 $31.60
Available brands
Revolade
space

ELTROMBOPAG

Source S100 HSD Private
Body System BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS
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
5827QMP ELTROMBOPAG
eltrombopag 25 mg tablet, 28 (PI, CMI)
1 28 5 $1276.79 $31.60 $31.60
Available brands
Revolade
space

ELTROMBOPAG

Source S100 HSD Private
Body System BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS
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
5828RMP ELTROMBOPAG
eltrombopag 50 mg tablet, 28 (PI, CMI)
1 28 5 $2504.91 $31.60 $31.60
Available brands
Revolade
space


  • Legend
  • MPMedical Practitioner