Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
5721DMP	EPOETIN ALFA epoetin alfa 4000 units/0.4 mL injection, 6 x 0.4 mL syringes (PI, CMI)	2	12	5	$535.14	$31.60	$31.60
	Available brands
	Eprex 4000

Source	S100 HSD Private
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
6206PMP	EPOETIN ALFA epoetin alfa 4000 units/0.4 mL injection, 6 x 0.4 mL syringes (PI, CMI)	2	12	5	$565.21	$31.60	$31.60
	Available brands
	Eprex 4000