Source	Chemotherapy Items for Public Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
11277MMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 1.2 g/20 mL injection, 20 mL vial)	1200 mg	7	$6838.60	$31.60	$31.60

Source	Chemotherapy Items for Public Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
11284XMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 1.2 g/20 mL injection, 20 mL vial)	1200 mg	5	$6838.60	$31.60	$31.60

Source	Chemotherapy Items for Private Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
11297NMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 1.2 g/20 mL injection, 20 mL vial)	1200 mg	7	$6978.73	$31.60	$31.60

Source	Chemotherapy Items for Private Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
11309FMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 1.2 g/20 mL injection, 20 mL vial)	1200 mg	5	$6978.73	$31.60	$31.60

Source	Chemotherapy Items for Private Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
11792PMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 1.2 g/20 mL injection, 20 mL vial)	1200 mg	5	$6978.73	$31.60	$31.60

Source	Chemotherapy Items for Private Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
11801DMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 1.2 g/20 mL injection, 20 mL vial)	1200 mg	7	$6978.73	$31.60	$31.60

Source	Chemotherapy Items for Public Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
11802EMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 1.2 g/20 mL injection, 20 mL vial)	1200 mg	7	$6838.60	$31.60	$31.60

Source	Chemotherapy Items for Public Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
11807KMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 1.2 g/20 mL injection, 20 mL vial)	1200 mg	5	$6838.60	$31.60	$31.60

Source	Chemotherapy Items for Public Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
11926QMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 1.2 g/20 mL injection, 20 mL vial)	1200 mg	3	$6838.60	$31.60	$31.60

Source	Chemotherapy Items for Private Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
11927RMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 1.2 g/20 mL injection, 20 mL vial)	1200 mg	3	$6978.73	$31.60	$31.60

Source	Chemotherapy Items for Private Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
11928TMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 1.2 g/20 mL injection, 20 mL vial)	1200 mg	4	$6978.73	$31.60	$31.60

Source	Chemotherapy Items for Public Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
11929WMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 1.2 g/20 mL injection, 20 mL vial)	1200 mg	4	$6838.60	$31.60	$31.60

Source	Chemotherapy Items for Public Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
11930XMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 840 mg/14 mL injection, 14 mL vial)	1680 mg	5	$9537.53	$31.60	$31.60

Source	Chemotherapy Items for Public Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
11931YMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 840 mg/14 mL injection, 14 mL vial)	1680 mg	3	$9537.53	$31.60	$31.60

Source	Chemotherapy Items for Private Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
11940KMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 840 mg/14 mL injection, 14 mL vial)	1680 mg	3	$9715.44	$31.60	$31.60

Source	Chemotherapy Items for Private Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
11957HMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 840 mg/14 mL injection, 14 mL vial)	1680 mg	5	$9715.44	$31.60	$31.60

Source	Chemotherapy Items for Private Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
12076NMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 840 mg/14 mL injection, 14 mL vial)	1680 mg	3	$9715.44	$31.60	$31.60

Source	Chemotherapy Items for Public Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
12078QMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 840 mg/14 mL injection, 14 mL vial)	1680 mg	3	$9537.53	$31.60	$31.60

Source	Chemotherapy Items for Public Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
12097QMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 840 mg/14 mL injection, 14 mL vial)	1680 mg	5	$9537.53	$31.60	$31.60

Source	Chemotherapy Items for Private Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
12098RMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 840 mg/14 mL injection, 14 mL vial)	1680 mg	5	$9715.44	$31.60	$31.60

Source	Chemotherapy Items for Private Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
12155RMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 1.2 g/20 mL injection, 20 mL vial)	1200 mg	8	$6978.73	$31.60	$31.60

Source	Chemotherapy Items for Private Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
12159YMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 840 mg/14 mL injection, 14 mL vial)	1680 mg	5	$9715.44	$31.60	$31.60

Source	Chemotherapy Items for Private Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Caution

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
12167JMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 1.2 g/20 mL injection, 20 mL vial)	1200 mg	3	$6978.73	$31.60	$31.60

Source	Chemotherapy Items for Public Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
12168KMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 1.2 g/20 mL injection, 20 mL vial)	1200 mg	8	$6838.60	$31.60	$31.60

Source	Chemotherapy Items for Public Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Caution

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
12171NMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 1.2 g/20 mL injection, 20 mL vial)	1200 mg	3	$6838.60	$31.60	$31.60

Source	Chemotherapy Items for Public Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
12174RMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 840 mg/14 mL injection, 14 mL vial)	1680 mg	5	$9537.53	$31.60	$31.60

Source	Chemotherapy Items for Private Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
13170EMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 840 mg/14 mL injection, 14 mL vial)	1680 mg	5	$9715.44	$31.60	$31.60

Source	Chemotherapy Items for Private Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
13172GMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 1.2 g/20 mL injection, 20 mL vial)	1200 mg	7	$6978.73	$31.60	$31.60

Source	Chemotherapy Items for Public Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
13173HMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 840 mg/14 mL injection, 14 mL vial)	1680 mg	5	$9537.53	$31.60	$31.60

Source	Chemotherapy Items for Public Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
13174JMP	ATEZOLIZUMAB Injection (PI, CMI) Available brands Tecentriq (atezolizumab 1.2 g/20 mL injection, 20 mL vial)	1200 mg	7	$6838.60	$31.60	$31.60

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

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
14225QMP	ATEZOLIZUMAB atezolizumab 1.875 g/15 mL injection, 15 mL vial (PI, CMI)	1	1	4	$6910.30	$31.60	$31.60
	Available brands
	Tecentriq SC

Source	Section 100 (CT)
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

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
14226RMP	ATEZOLIZUMAB atezolizumab 1.875 g/15 mL injection, 15 mL vial (PI, CMI)	1	1	4	$6747.37	$31.60	$31.60
	Available brands
	Tecentriq SC

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

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
14247WMP	ATEZOLIZUMAB atezolizumab 1.875 g/15 mL injection, 15 mL vial (PI, CMI)	1	1	5	$6910.30	$31.60	$31.60
	Available brands
	Tecentriq SC

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

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
14248XMP	ATEZOLIZUMAB atezolizumab 1.875 g/15 mL injection, 15 mL vial (PI, CMI)	1	1	3	$6910.30	$31.60	$31.60
	Available brands
	Tecentriq SC

Source	Section 100 (CT)
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

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
14249YMP	ATEZOLIZUMAB atezolizumab 1.875 g/15 mL injection, 15 mL vial (PI, CMI)	1	1	7	$6747.37	$31.60	$31.60
	Available brands
	Tecentriq SC

Source	Section 100 (CT)
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

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
14250BMP	ATEZOLIZUMAB atezolizumab 1.875 g/15 mL injection, 15 mL vial (PI, CMI)	1	1	5	$6747.37	$31.60	$31.60
	Available brands
	Tecentriq SC

Source	Section 100 (CT)
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

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
14255GMP	ATEZOLIZUMAB atezolizumab 1.875 g/15 mL injection, 15 mL vial (PI, CMI)	1	1	7	$6747.37	$31.60	$31.60
	Available brands
	Tecentriq SC

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

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
14266WMP	ATEZOLIZUMAB atezolizumab 1.875 g/15 mL injection, 15 mL vial (PI, CMI)	1	1	5	$6910.30	$31.60	$31.60
	Available brands
	Tecentriq SC

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

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
14267XMP	ATEZOLIZUMAB atezolizumab 1.875 g/15 mL injection, 15 mL vial (PI, CMI)	1	1	7	$6910.30	$31.60	$31.60
	Available brands
	Tecentriq SC

Source	Section 100 (CT)
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

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
14268YMP	ATEZOLIZUMAB atezolizumab 1.875 g/15 mL injection, 15 mL vial (PI, CMI)	1	1	7	$6747.37	$31.60	$31.60
	Available brands
	Tecentriq SC

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

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
14269BMP	ATEZOLIZUMAB atezolizumab 1.875 g/15 mL injection, 15 mL vial (PI, CMI)	1	1	7	$6910.30	$31.60	$31.60
	Available brands
	Tecentriq SC

Source	Section 100 (CT)
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Caution

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
14277KMP	ATEZOLIZUMAB atezolizumab 1.875 g/15 mL injection, 15 mL vial (PI, CMI)	1	1	3	$6747.37	$31.60	$31.60
	Available brands
	Tecentriq SC

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Caution

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
14278LMP	ATEZOLIZUMAB atezolizumab 1.875 g/15 mL injection, 15 mL vial (PI, CMI)	1	1	3	$6910.30	$31.60	$31.60
	Available brands
	Tecentriq SC

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

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
14288BMP	ATEZOLIZUMAB atezolizumab 1.875 g/15 mL injection, 15 mL vial (PI, CMI)	1	1	7	$6910.30	$31.60	$31.60
	Available brands
	Tecentriq SC

Source	Section 100 (CT)
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

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
14289CMP	ATEZOLIZUMAB atezolizumab 1.875 g/15 mL injection, 15 mL vial (PI, CMI)	1	1	3	$6747.37	$31.60	$31.60
	Available brands
	Tecentriq SC

Source	Section 100 (CT)
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

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
14298MMP	ATEZOLIZUMAB atezolizumab 1.875 g/15 mL injection, 15 mL vial (PI, CMI)	1	1	5	$6747.37	$31.60	$31.60
	Available brands
	Tecentriq SC

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

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
14566PMP	ATEZOLIZUMAB atezolizumab 1.875 g/15 mL injection, 15 mL vial (PI, CMI)	1	1	8	$6910.30	$31.60	$31.60
	Available brands
	Tecentriq SC

Source	Section 100 (CT)
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

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
14575DMP	ATEZOLIZUMAB atezolizumab 1.875 g/15 mL injection, 15 mL vial (PI, CMI)	1	1	8	$6747.37	$31.60	$31.60
	Available brands
	Tecentriq SC