Source	General Schedule
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
12360MMP	ADALIMUMAB adalimumab 80 mg/0.8 mL injection, 0.8 mL pen device (PI, CMI)	3	3	0	$2014.38	$31.60	$31.60
	Available brands
	Humira

Source	General Schedule
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
12374GMP	ADALIMUMAB adalimumab 80 mg/0.8 mL injection, 0.8 mL pen device (PI, CMI)	3	3	0	$2014.38	$31.60	$31.60
	Available brands
	Humira

Source	General Schedule
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
12419PMP	ADALIMUMAB adalimumab 80 mg/0.8 mL injection, 0.8 mL pen device (PI, CMI)	3	3	0	$2014.38	$31.60	$31.60
	Available brands
	Humira

Source	General Schedule
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
12426BMP	ADALIMUMAB adalimumab 80 mg/0.8 mL injection, 0.8 mL pen device (PI, CMI)	3	3	0	$2014.38	$31.60	$31.60
	Available brands
	Humira

Source	General Schedule
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
12447DMP	ADALIMUMAB adalimumab 80 mg/0.8 mL injection, 0.8 mL pen device (PI, CMI)	1	1	0	$676.79	$31.60	$31.60
	Available brands
	Humira

Source	General Schedule
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
12448EMP	ADALIMUMAB adalimumab 80 mg/0.8 mL injection, 0.8 mL pen device (PI, CMI)	2	2	5	$1345.59	$31.60	$31.60
	Available brands
	Humira

Source	General Schedule
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
12449FMP	ADALIMUMAB adalimumab 80 mg/0.8 mL injection, 0.8 mL pen device (PI, CMI)	2	2	2	$1345.59	$31.60	$31.60
	Available brands
	Humira

Source	General Schedule
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
12450GMP	ADALIMUMAB adalimumab 80 mg/0.8 mL injection, 0.8 mL pen device (PI, CMI)	3	3	0	$2014.38	$31.60	$31.60
	Available brands
	Humira