APOMORPHINE

APOMORPHINE (11475Y)

apomorphine hydrochloride hemihydrate 30 mg/3 mL injection, 5 x 3 mL pen devices
11475Y
Body System:
Manner of administration:Injection
Private
S100 HSD Private
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 10830)

Indication: Parkinson disease
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 20 Max qty units: 100 # of repeats: 5 DPMQ: $2,636.88 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Movapo Pen

APOMORPHINE (11477C)

apomorphine hydrochloride hemihydrate 30 mg/3 mL injection, 5 x 3 mL pen devices
11477C
Body System:
Manner of administration:Injection
Public
S100 HSD Public
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 10863)

Indication: Parkinson disease
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 20 Max qty units: 100 # of repeats: 5 DPMQ: $2,588.00 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Movapo Pen

APOMORPHINE (12137T)

apomorphine hydrochloride hemihydrate 30 mg/3 mL injection, 5 x 3 mL pen devices
12137T
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: 20 Max qty units: 100 # of repeats: 5 DPMQ: $2,723.88 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Movapo Pen

APOMORPHINE (14485J)

apomorphine hydrochloride hemihydrate 30 mg/3 mL injection, 5 x 3 mL pen devices
14485J
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: 40 Max qty units: 200 # of repeats: 5 DPMQ: $5,338.88 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Movapo Pen