APOMORPHINE

APOMORPHINE (10950H)

apomorphine hydrochloride hemihydrate 50 mg/10 mL injection, 5 x 10 mL syringes
10950H
Body System:
Manner of administration:Injection
Public
S100 HSD Public
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 11385)

Indication: Parkinson disease
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 36 Max qty units: 180 # of repeats: 5 DPMQ: $8,017.20 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Movapo PFS

APOMORPHINE (10971K)

apomorphine hydrochloride hemihydrate 50 mg/10 mL injection, 5 x 10 mL syringes
10971K
Body System:
Manner of administration:Injection
Private
S100 HSD Private
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 11445)

Indication: Parkinson disease
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 36 Max qty units: 180 # of repeats: 5 DPMQ: $8,066.04 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Movapo PFS

APOMORPHINE (12319J)

apomorphine hydrochloride hemihydrate 50 mg/10 mL injection, 5 x 10 mL syringes
12319J
Body System:
Manner of administration:Injection
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 10844)

Indication: Parkinson disease
Treatment phase: Maintenance therapy
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 36 Max qty units: 180 # of repeats: 5 DPMQ: $8,153.16 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Movapo PFS

APOMORPHINE (14377Q)

apomorphine hydrochloride hemihydrate 50 mg/10 mL injection, 5 x 10 mL syringes
14377Q
Body System:
Manner of administration:Injection
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 15542)

Indication: Parkinson disease
Treatment phase: Maintenance therapy
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 72 Max qty units: 360 # of repeats: 5 DPMQ: $16,197.36 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Movapo PFS