INFLIXIMAB

infliximab 100 mg injection, 1 vial

INFLIXIMAB (11486M)

infliximab 100 mg injection, 1 vial
11486M
Body System:
Manner of administration:Injection
Public
S100 HSD Public
Authority Required (STREAMLINED)

Restriction  14683

Indication: Ankylosing spondylitis
Treatment phase: First continuing treatment

Restriction  14701

Indication: Ankylosing spondylitis
Treatment phase: Subsequent continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 5 Max qty units: 5 # of repeats: 3 DPMQ: $930.80 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Inflectra
Ixifi
Remsima
Renflexis