HCL Non-Funded Vaccines* - Consolidated Order Form

HCL Non-Funded Vaccines* - Consolidated Order Form
Order Online: www.hconline.co.nz
(as at 22 Jan 2014)
(use PC code in bold).
(please destroy older version)
Free Fax 0508 408 358
email to: [email protected] or
Business Name
HCL Account #
Delivery Address
Customer Order Ref
Contact Name
Phone
Before prescribing a vaccine please review full datasheet – www.medsafe.govt.nz
*All purchases will be invoiced at the current price. Prices quoted are valid as at above date of issue, subject to change; all prices are excluding of GST.
Product
Qty
NeisVac-C™ PFS Single Dose
Meningococcal C
1114467 PC 1114467 $43.00
NeisVac-C™ PFS 10 Dose Pack
Meningococcal C
1114454 PC 1114454 $430.00
Product
Qty
Boostrix® pre-filled syringe
Product
Adacel® Vial
Diphtheria/Tetanus/Pertussis
1049350 PC 2061996 $25.00
Diphtheria/Tetanus/Pertussis
1077023 PC 2297280
$25.00
Engerix-B® PFS
Adacel Polio® PFS
Hepatitis B
1038260 PC 2061945
19.50
Diphtheria/Tetanus/Pertussis plus Polio
1076065 PC 2288192
$54.00
Avaxim™ PFS
Havrix® Vial
Hepatitis A
Hepatitis A
Diphtheria & Tetanus
1073579 PC 2230062 $84.83
1038263 PC 2061937 $63.80
Havrix® pre-filled syringe
IPOL PFS
Dukoral®
Hepatitis A
ADT™ Booster 5 pack PFS
Oral, Cholera/Travellers' Diarrhoea
1113134 PC 2119471 $35.00
GARDASIL® PFS non-funded
Qty
1039005 PC 282502
Havrix Junior® PFS
$63.80
Hepatitis A
1121450 PC 2102774
Poliomyelitis
1070339 PC 216909
$63.80
$40.00
Menactra® Vial
Meningococcal ACW & Y Conjugate
1113087 PC 1113087
$89.95
Quad HPV (types 6,11,16,18)
1068212 PC 2212625 $128.50
1038264 PC 793582 $32.00
Hepatyrix® No Supply, ETA end Q4
Jespect® PFS
Hepatitis A / Typhoid Fever
Meningococcal ACW & Y Polysaccharide
1070360 PC 678872
$30.00
Japanese Encephalitis
Malarone® tablets
Pneumo23® PFS
(12 Tabs/pack)
Malaria
1050297 PC 1050297 $64.00
Polysaccharide pneumococcal vaccine
1040177 PC 440663
$37.50
1081273 PC2312700 $166.00
Vivotif®
- 3 capsules
Typhoid live attenuated (oral) vaccine
1115491 PC 2401177 $29.50
PNEUMOVAX®23 Vial
Pneumococcal (polysaccharide)
1012568 PC 296341 $40.00
VARIVAX® Vial
Varicella/chickenpox
1070367 PC 2173085 $50.00
Prevenar 13® pre-filled syringe
PCV 13-valent
1088608 PC 1088608 $168.20
Menomune™ Vial – out of stock
Malarone® tablets Junior
Stamaril® Vial
- WHO Approved Clinics only -
(12 Tabs/pack)
Malaria
1111370 PC 2385538 $25.00
Yellow Fever (provide Stamp below)
1070343 PC 471615
$60.00
Tubersol® 10 dose vial
Mencevax® ACWY Vial
Tuberculosis Test
1070355 PC 1070355
Meningitis ACW & Y
1038270 PC 2061961 $30.00
Rotarix® Oral Dose Twin Pack
PF Applicator
Rotavirus
1112162 PC 1112162 $160.00
Limited offer 37.5% discount off $160
N/A
$15.00
Typhim VI™ PFS
Typhoid Fever
1070356 PC 200697
$35.00
Verorab™ Vial+Syringe
Rabies
1077755 PC 1077755
Twinrix® PFS
Vivaxim® PFS
Hepatitis A / Hepatitis B
1038268 PC 2061910 $60.00
Hepatitis A / Typhoid Fever
1070358 PC 2181878
$95.00
$95.00
Twinrix® Junior PFS
Meningitec® pre-filled syringe
Hepatitis A / Hepatitis B
1038265 PC 2061929 $32.00
Conjugate Meningococcal C
1072554 PC 1072554 $51.00
Typherix®
Bulk buy 5+ units $49.50 ea
Varilrix® Vial
No Supply, ETA end Q4
Ordering Stamaril® ?
Typhoid Fever
Place WHO Yellow Fever Stamp here
Varicella
1038273 PC 409324
$50.00
Doctor’s Name:
Doctor’s Registration #
Lariam® tablets (8 Tabs/pack)
Malaria
1010625 PC 769886
$33.48
Place Surgery Stamp here
Orders of 1 - 4 (mixed) units incur a $45 Small Order Handling Fee.
Orders of 5 and above (mixed) units are exempt from the Small Order Handling Fee.
HCL Customer Service – (09) 969 0736

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