Nappi Name Action Status Rules
Non-F Reject Non- Formulary item. See particular scheme benefit. Apply where applicable
500767 0.5ML INSULIN SYRINGE 320921 EA ZZZ Allow Reject / Chronic Step: Only allowed with insulin & quantity limitation. No application
534636 01ML BD SYRINGE 305501 EA ZZZ Allow Reject / Chronic Step: Only allowed with insulin & quantity limitation. No application
693103 01ML INSULIN SYRINGE 5D-10220 EA ZZZ Allow Reject / Chronic Step: Only allowed with insulin & quantity limitation. No application
821632 3TC 150mg. TABLETS CEF-Apply Reject/ PreAuth Register on DM programme. Pre-authorisation required. Submit pathology reports and HIV form to fax (012) 673 5549.
821640 3TC Soln. SOLN. ORAL CEF-Apply Reject/ PreAuth Register on DM programme. Pre-authorisation required. Submit pathology reports and HIV form to fax (012) 673 5549.
894266 5-HTP Excl Excluded Excluded - Evening Primrose Oil
898105 5-HTP Excl Excluded Excluded - Evening Primrose Oil
701477 9 MONTHS + Allow Acute - no application Limited to 30 capsules per month & 9 fills
700029 AAA MOUTH THROAT Allow Acute - no application Price limitation & limited to 1 fill per year
701080 ABANA E Excluded Excluded - Patent homeopathic medicine.
872601 ABBOTT-ATRACURIUM 2.5ML Excl Excluded Excluded, injections included in consultation fee
872628 ABBOTT-DOBUTAMINE 20ML Excl Excluded Excluded, injections included in consultation fee
832286 ABBOTT-PROPOFOL 20ML AMP Excl Excluded Excluded, injections included in consultation fee
850713 ABBOTT-PROPOFOL 20ML VIAL Excl Excluded Excluded, injections included in consultation fee
832294 ABBOTT-PROPOFOL 50ML Excl Excluded Excluded, injections included in consultation fee
848638 ABBOTT-VANCOMYCIN VIAL Excl Excluded Excluded, injections included in consultation fee
861413 ABBOTT-VANCOMYCIN VIAL Excl Excluded Excluded, injections included in consultation fee
826766 ABFLEX 4 CEF Acute - no application Price limitation. Limited to 20 tablets & 6 fills per year.
787361 ABIC CARBOPLATIN 150mg. vial Inject. Soln. Non-F Reject/ PreAuth Specialist initiated only. Pre Auth for Oncology benefits. Obtain application form by dialling Fax on Demand Service from fax machine (Form no. 2004)
787388 ABIC CARBOPLATIN 450mg. vial Inject. Soln. Non-F Reject/ PreAuth Specialist initiated only. Pre Auth for Oncology benefits. Obtain application form by dialling Fax on Demand Service from fax machine (Form no. 2004)
856207 ABIC CARBOPLATIN SOLUTION Non-F Reject/ PreAuth Specialist initiated only. Pre Auth for Oncology benefits. Obtain application form by dialling Fax on Demand Service from fax machine (Form no. 2004)
856215 ABIC CARBOPLATIN SOLUTION Non-F Reject/ PreAuth Specialist initiated only. Pre Auth for Oncology benefits. Obtain application form by dialling Fax on Demand Service from fax machine (Form no. 2004)
800031 ABIC ETOPOSIDE 20mg./ml. vial Inject. Non-F Reject/ PreAuth Specialist initiated only. Pre Auth for Oncology benefits. Obtain application form by dialling Fax on Demand Service from fax machine (Form no. 2004)
782491 ABIC FLUOROURACIL 50mg./ml. x10ml.amp INJECT. CEF-Apply Reject/ PreAuth Specialist initiated only. Pre Auth for Oncology benefits. Obtain application form by dialling Fax on Demand Service from fax machine (Form no. 2004)
782483 ABIC FLUOROURACIL 50mg./ml. x5ml.amp INJECT. CEF-Apply Reject/ PreAuth Specialist initiated only. Pre Auth for Oncology benefits. Obtain application form by dialling Fax on Demand Service from fax machine (Form no. 2004)
704608 ABIC LEUCOVORIN 100MG/10ML Non-F Excluded Excluded, injections included in consultation fee
704609 ABIC LEUCOVORIN 200MG/20ML Non-F Excluded Excluded, injections included in consultation fee
704610 ABIC LEUCOVORIN 300MG/30ML Non-F Excluded Excluded, injections included in consultation fee
785180 ABIC LEUCOVORIN 3mg./ml.amp. x1ml.amp Inject. Non-F Excluded Excluded, injections included in consultation fee, apply for oncology benefits
792403 ABIC LEUCOVORIN 50mg. vial Inject. Non-F Excluded Excluded, injections included in consultation fee, apply for oncology benefits
705634 ABILIFY 10 mg Non-F Reject Rejected - conventional anti-psychotics preferred and on the automated list.
705635 ABILIFY 15 mg Non-F Reject Rejected - conventional anti-psychotics preferred and on the automated list.
705636 ABILIFY 30mg Non-F Reject Rejected - conventional anti-psychotics preferred and on the automated list.
782505 ABIPLATIN 10mg. vial Inject./Powder CEF-Apply Reject/ PreAuth Specialist initiated only. Pre Auth for Oncology benefits. Obtain application form by dialling Fax on Demand Service from fax machine (Form no. 2004)
795798 ABIPLATIN 10mg./20ml. x20ml.vial Inject./Soln. CEF-Apply Reject/ PreAuth Specialist initiated only. Pre Auth for Oncology benefits. Obtain application form by dialling Fax on Demand Service from fax machine (Form no. 2004)
782513 ABIPLATIN 50mg. vial Inject./Powder CEF-Apply Reject/ PreAuth Specialist initiated only. Pre Auth for Oncology benefits. Obtain application form by dialling Fax on Demand Service from fax machine (Form no. 2004)
782521 ABIPLATIN 50mg./100ml. 100ml.vial Inject./Soln. CEF-Apply Reject/ PreAuth Specialist initiated only. Pre Auth for Oncology benefits. Obtain application form by dialling Fax on Demand Service from fax machine (Form no. 2004)
782564 ABITREXATE 1G 100mg./ml. x10ml.vial Inject. Vial CEF-Apply Reject/ PreAuth Specialist initiated only. Pre Auth for Oncology benefits. Obtain application form by dialling Fax on Demand Service from fax machine (Form no. 2004)
782548 ABITREXATE 50 25mg./ml. x2ml.amp Inject. Amp CEF-Apply Reject/ PreAuth Specialist initiated only. Pre Auth for Oncology benefits. Obtain application form by dialling Fax on Demand Service from fax machine (Form no. 2004)
782556 ABITREXATE 500 25mg./ml. x20ml.vial Inject. Vial CEF-Apply Reject/ PreAuth Specialist initiated only. Pre Auth for Oncology benefits. Obtain application form by dialling Fax on Demand Service from fax machine (Form no. 2004)
701110 ABITREXATE-5G 50ML CEF-Apply Reject/ PreAuth Specialist initiated only. Pre Auth for Oncology benefits. Obtain application form by dialling Fax on Demand Service from fax machine (Form no. 2004)
844063 ABROPERNOL E Excluded Excluded - Patent homeopathic medicine.
810436 AC ACETIC GLACIAL Excl Excluded Excluded - Galenicals
894227 AC CITRIC Excl Excluded Excluded - Galenicals
848689 AC GLYCOLIC Excl Excluded Excluded - Patent medicine
700258 ACACIA GUM Excl Excluded Excluded - Galenicals
824291 ACC 200 EFF 200mg. Tablets Eff Excl Excluded Excluded - Inconclusive benefit/risk ratio
892580 ACCOLATE 20mg. Tablets Non-F Excluded Rejected as first line treatment: Budesonide/beclomethasone MDI is the preferred treatment for asthma.
895053 ACCU-CET HOSPITAL CONCENT Excl Excluded Excluded - Soap, scrubs, cleanser
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