Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSTIMULANTS > IMMUNOSTIMULANTS

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
2733WMP	FILGRASTIM filgrastim 480 microgram/0.5 mL injection, 5 x 0.5 mL syringes (PI, CMI)	4	20	11	$400.35	$31.60	$31.60
	Available brands
	Zarzioa

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSTIMULANTS > IMMUNOSTIMULANTS

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
2747NMP	FILGRASTIM filgrastim 300 microgram/0.5 mL injection, 5 x 0.5 mL syringes (PI, CMI)	4	20	11	$252.99	$31.60	$31.60
	Available brands
	Zarzioa

Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSTIMULANTS > IMMUNOSTIMULANTS

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
2758EMP	FILGRASTIM filgrastim 300 microgram/0.5 mL injection, 5 x 0.5 mL syringes (PI, CMI)	4	20	11	$234.92	$31.60	$31.60
	Available brands
	Zarzioa

Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSTIMULANTS > IMMUNOSTIMULANTS

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
2783LMP	FILGRASTIM filgrastim 480 microgram/0.5 mL injection, 5 x 0.5 mL syringes (PI, CMI)	4	20	11	$376.60	$31.60	$31.60
	Available brands
	Zarzioa

Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSTIMULANTS > IMMUNOSTIMULANTS

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
5742FMP	FILGRASTIM filgrastim 300 microgram/0.5 mL injection, 10 x 0.5 mL syringes (PI, CMI)	2	20	11	$234.92	$31.60	$31.60
	Available brands
	Nivestima

Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSTIMULANTS > IMMUNOSTIMULANTS

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
5744HMP	FILGRASTIM filgrastim 480 microgram/0.5 mL injection, 10 x 0.5 mL syringes (PI, CMI)	2	20	11	$376.60	$31.60	$31.60
	Available brands
	Nivestima

Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSTIMULANTS > IMMUNOSTIMULANTS

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
5829TMP	FILGRASTIM filgrastim 120 microgram/0.2 mL injection, 10 x 0.2 mL syringes (PI, CMI)	2	20	11	$247.68	$31.60	$31.60
	Available brands
	Nivestim

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSTIMULANTS > IMMUNOSTIMULANTS

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
5830WMP	FILGRASTIM filgrastim 120 microgram/0.2 mL injection, 10 x 0.2 mL syringes (PI, CMI)	2	20	11	$266.25	$31.60	$31.60
	Available brands
	Nivestim

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSTIMULANTS > IMMUNOSTIMULANTS

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
6291DMP	FILGRASTIM filgrastim 300 microgram/0.5 mL injection, 10 x 0.5 mL syringes (PI, CMI)	2	20	11	$252.99	$31.60	$31.60
	Available brands
	Nivestima

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSTIMULANTS > IMMUNOSTIMULANTS

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
6292EMP	FILGRASTIM filgrastim 480 microgram/0.5 mL injection, 10 x 0.5 mL syringes (PI, CMI)	2	20	11	$400.33	$31.60	$31.60
	Available brands
	Nivestima