FOLLITROPIN ALFA

Source S100 IVF
Body System GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS
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
6432MMP FOLLITROPIN ALFA
follitropin alfa 450 units (32.76 microgram)/0.75 mL injection, 0.75 mL pen device (PI, CMI)
2 2 0 $278.31 $31.60 $31.60
Available brands
Gonal-f Pena
space

FOLLITROPIN ALFA

Source General Schedule
Body System GENITO URINARY SYSTEM AND SEX HORMONES > SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM > GONADOTROPINS AND OTHER OVULATION STIMULANTS
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
8714PMP FOLLITROPIN ALFA
follitropin alfa 450 units (32.76 microgram)/0.75 mL injection, 0.75 mL pen device (PI, CMI)
3 3 5 $447.51 $31.60 $31.60
Available brands
Gonal-f Pena
space


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