ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
10399HMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
1 2 0 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
10400JMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
1 2 0 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
10412BMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
10413CMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
1 2 2 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
10419JMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
1 2 2 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
10420KMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
10944BMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
1 2 2 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
10955NMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
1 2 2 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
10960WMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
10961XMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12325QMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12326RMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12327TMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12328WMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12329XMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12330YMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
2 4 5 $1763.98 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12331BMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
3 6 0 $2616.92 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12332CMP ADALIMUMAB
adalimumab 20 mg/0.4 mL injection, 0.4 mL syringe (PI, CMI)
2 2 3 $923.46 $42.50 $42.50
Available brands
Amgevitaa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12333DMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
3 6 0 $2616.92 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12334EMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source S100 HSD Private
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12335FMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 0 $859.10 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12337HMP ADALIMUMAB
adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes (PI, CMI)
1 2 5 $923.45 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12338JMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 2 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12339KMP ADALIMUMAB
adalimumab 80 mg/0.8 mL injection, 0.8 mL syringe (PI, CMI)
3 3 0 $2616.92 $42.50 $42.50
Available brands
Humira
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12340LMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 2 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12341MMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12342NMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 4 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12345RMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 2 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12347WMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
3 6 0 $2616.92 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source S100 HSD Public
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12348XMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
1 2 5 $818.54 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source S100 HSD Private
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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 $859.10 $42.50 $42.50
Available brands
Amgevita
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12350BMP ADALIMUMAB
adalimumab 20 mg/0.4 mL injection, 0.4 mL syringe (PI, CMI)
2 2 3 $923.46 $42.50 $42.50
Available brands
Amgevitaa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12351CMP ADALIMUMAB
adalimumab 20 mg/0.4 mL injection, 0.4 mL syringe (PI, CMI)
2 2 5 $923.46 $42.50 $42.50
Available brands
Amgevita
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12352DMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12353EMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12354FMP ADALIMUMAB
adalimumab 20 mg/0.4 mL injection, 0.4 mL syringe (PI, CMI)
2 2 0 $923.46 $42.50 $42.50
Available brands
Amgevitaa
space

ADALIMUMAB

Source S100 HSD Public
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12355GMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
1 2 5 $818.54 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12356HMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
3 6 0 $2616.92 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12357JMP ADALIMUMAB
adalimumab 20 mg/0.4 mL injection, 0.4 mL syringe (PI, CMI)
2 2 5 $923.46 $42.50 $42.50
Available brands
Amgevitaa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12358KMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12359LMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 2 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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 $2616.92 $42.50 $42.50
Available brands
Humira
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12361NMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12362PMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 3 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12363QMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12364RMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 3 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12365TMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12366WMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12367XMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source S100 HSD Private
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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 $859.10 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12369BMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
2 4 5 $1763.98 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12370CMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
3 6 0 $2616.92 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12371DMP ADALIMUMAB
adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes (PI, CMI)
1 2 3 $923.45 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12372EMP ADALIMUMAB
adalimumab 80 mg/0.8 mL injection, 0.8 mL syringe (PI, CMI)
3 3 0 $2616.92 $42.50 $42.50
Available brands
Humira
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12373FMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 2 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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 $2616.92 $42.50 $42.50
Available brands
Humira
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12375HMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12376JMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 3 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12377KMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12378LMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 3 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12379MMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 0 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12380NMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
3 6 0 $2616.92 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12381PMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
3 6 0 $2616.92 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12382QMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
3 6 0 $2616.92 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12383RMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
2 4 2 $1763.98 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source S100 HSD Private
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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 $859.10 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12385WMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
2 4 2 $1763.98 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12386XMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
3 6 0 $2616.92 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12387YMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
3 6 0 $2616.92 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12388BMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
3 6 0 $2616.92 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12389CMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12390DMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12391EMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12393GMP ADALIMUMAB
adalimumab 80 mg/0.8 mL injection, 0.8 mL syringe (PI, CMI)
3 3 0 $2616.92 $42.50 $42.50
Available brands
Humira
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12394HMP ADALIMUMAB
adalimumab 80 mg/0.8 mL injection, 0.8 mL syringe (PI, CMI)
1 1 0 $885.56 $42.50 $42.50
Available brands
Humira
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12395JMP ADALIMUMAB
adalimumab 80 mg/0.8 mL injection, 0.8 mL syringe (PI, CMI)
2 2 2 $1763.98 $42.50 $42.50
Available brands
Humira
space

ADALIMUMAB

Source S100 HSD Private
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12396KMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 0 $859.10 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12397LMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 2 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12398MMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12399NMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12400PMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 3 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12401QMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12402RMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
3 6 0 $2616.92 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12403TMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12405XMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source S100 HSD Public
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12406YMP ADALIMUMAB
adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes (PI, CMI)
1 2 0 $818.54 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12407BMP ADALIMUMAB
adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes (PI, CMI)
1 2 3 $923.45 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12408CMP ADALIMUMAB
adalimumab 80 mg/0.8 mL injection, 0.8 mL syringe (PI, CMI)
2 2 5 $1763.98 $42.50 $42.50
Available brands
Humira
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12409DMP ADALIMUMAB
adalimumab 80 mg/0.8 mL injection, 0.8 mL syringe (PI, CMI)
3 3 0 $2616.92 $42.50 $42.50
Available brands
Humira
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12410EMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12411FMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 0 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12412GMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 2 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12413HMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12414JMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
2 4 5 $1763.98 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12415KMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12416LMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
3 6 0 $2616.92 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source S100 HSD Public
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12417MMP ADALIMUMAB
adalimumab 20 mg/0.4 mL injection, 0.4 mL syringe (PI, CMI)
2 2 5 $818.54 $42.50 $42.50
Available brands
Amgevita
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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 $2616.92 $42.50 $42.50
Available brands
Humira
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12420QMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12421RMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 4 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12422TMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12423WMP ADALIMUMAB
adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes (PI, CMI)
1 2 0 $923.45 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12424XMP ADALIMUMAB
adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes (PI, CMI)
1 2 5 $923.45 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12425YMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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 $2616.92 $42.50 $42.50
Available brands
Humira
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12428DMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 3 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12429EMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 3 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12430FMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source S100 HSD Public
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12431GMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 0 $818.54 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12432HMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
3 6 0 $2616.92 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12433JMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
3 6 0 $2616.92 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12434KMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source S100 HSD Public
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12435LMP ADALIMUMAB
adalimumab 20 mg/0.4 mL injection, 0.4 mL syringe (PI, CMI)
2 2 0 $818.54 $42.50 $42.50
Available brands
Amgevitaa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12436MMP ADALIMUMAB
adalimumab 20 mg/0.4 mL injection, 0.4 mL syringe (PI, CMI)
2 2 5 $923.46 $42.50 $42.50
Available brands
Amgevita
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12437NMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12438PMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source S100 HSD Private
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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 $859.10 $42.50 $42.50
Available brands
Amgevitaa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12440RMP ADALIMUMAB
adalimumab 20 mg/0.4 mL injection, 0.4 mL syringe (PI, CMI)
2 2 5 $923.46 $42.50 $42.50
Available brands
Amgevitaa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12442WMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 3 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source S100 HSD Private
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12443XMP ADALIMUMAB
adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes (PI, CMI)
1 2 0 $859.10 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source S100 HSD Public
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12444YMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 0 $818.54 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12446CMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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 $885.56 $42.50 $42.50
Available brands
Humira
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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 $1763.98 $42.50 $42.50
Available brands
Humira
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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 $1763.98 $42.50 $42.50
Available brands
Humira
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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 $2616.92 $42.50 $42.50
Available brands
Humira
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12451HMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 2 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12453KMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
3 6 0 $2616.92 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12454LMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
3 6 0 $2616.92 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12455MMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
3 6 0 $2616.92 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12524EMP ADALIMUMAB
adalimumab 80 mg/0.8 mL injection, 0.8 mL syringe (PI, CMI)
3 3 0 $2616.92 $42.50 $42.50
Available brands
Humira
space

ADALIMUMAB

Source S100 HSD Private
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12674CMP ADALIMUMAB
adalimumab 20 mg/0.4 mL injection, 0.4 mL syringe (PI, CMI)
2 2 0 $859.10 $42.50 $42.50
Available brands
Amgevitaa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12678GMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source S100 HSD Private
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12686QMP ADALIMUMAB
adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes (PI, CMI)
1 2 0 $859.10 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12690XMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source S100 HSD Public
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12695EMP ADALIMUMAB
adalimumab 20 mg/0.4 mL injection, 0.4 mL syringe (PI, CMI)
2 2 0 $818.54 $42.50 $42.50
Available brands
Amgevitaa
space

ADALIMUMAB

Source S100 HSD Public
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12696FMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 0 $818.54 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source S100 HSD Public
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12697GMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 0 $818.54 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source S100 HSD Public
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12698HMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
1 2 0 $818.54 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source S100 HSD Public
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12699JMP ADALIMUMAB
adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes (PI, CMI)
1 2 0 $818.54 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12700KMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12701LMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source S100 HSD Private
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12715FMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
1 2 0 $859.10 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12719KMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12729YMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source S100 HSD Private
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12731CMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
1 2 0 $859.10 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source S100 HSD Private
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12732DMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)
1 2 0 $859.10 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source S100 HSD Public
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12733EMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
1 2 0 $818.54 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12741NMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source S100 HSD Private
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12749BMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 0 $859.10 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
12752EMP ADALIMUMAB
adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Humiraa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
5281YMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
1 2 3 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
5282BMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
1 2 3 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
5283CMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
5284DMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
8737WMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
1 2 3 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
8741CMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
1 2 5 $885.56 $42.50 $42.50
Available brands
Amgevitaa
Hadlimaa
Hyrimoza
Idacioa
space

ADALIMUMAB

Source General Schedule
Body System ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS
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
8963RMP ADALIMUMAB
adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)
1 2 2 $885.56 $42.50 $42.50
Available brands