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

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
12349YMP	ADALIMUMAB adalimumab 20 mg/0.4 mL injection, 0.4 mL syringe (PI, CMI)	2	2	5	$652.33	$31.60	$31.60
	Available brands
	Amgevitaa

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

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
12368YMP	ADALIMUMAB adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)	1	2	5	$534.86	$31.60	$31.60
	Available brands
	Abriladaa
	Amgevitaa
	Hadlimaa
	Hyrimoza

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

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
12384TMP	ADALIMUMAB adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)	1	2	5	$534.86	$31.60	$31.60
	Available brands
	Abriladaa
	Amgevitaa
	Hadlimaa
	Hyrimoza

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

Note

Authority Required

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
12439QMP	ADALIMUMAB adalimumab 20 mg/0.4 mL injection, 0.4 mL syringe (PI, CMI)	2	2	0	$652.33	$31.60	$31.60
	Available brands
	Amgevitaa

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

Note

Authority Required

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
9679KMP	ADALIMUMAB adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)	1	2	0	$534.86	$31.60	$31.60
	Available brands
	Abriladaa
	Amgevitaa
	Hadlimaa
	Hyrimoza

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

Note

Authority Required

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
9680LMP	ADALIMUMAB adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)	1	2	0	$534.86	$31.60	$31.60
	Available brands
	Abriladaa
	Amgevitaa
	Hadlimaa
	Hyrimoza