APOMORPHINE

APOMORPHINE (15111H)

Apomorphine hydrochloride hemihydrate 100 mg/20 mL injection, 5 x 20 mL cartridges
15111H
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: 18 Max qty units: 90 # of repeats: 5 DPMQ: $7,427.34 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
MOVAPO POD

APOMORPHINE (15118Q)

Apomorphine hydrochloride hemihydrate 100 mg/20 mL injection, 5 x 20 mL cartridges
15118Q
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: 18 Max qty units: 90 # of repeats: 5 DPMQ: $7,563.12 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
MOVAPO POD

APOMORPHINE (15121W)

Apomorphine hydrochloride hemihydrate 100 mg/20 mL injection, 5 x 20 mL cartridges
15121W
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: 36 Max qty units: 180 # of repeats: 5 DPMQ: $15,017.64 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
MOVAPO POD

APOMORPHINE (15132K)

Apomorphine hydrochloride hemihydrate 100 mg/20 mL injection, 5 x 20 mL cartridges
15132K
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: 18 Max qty units: 90 # of repeats: 5 DPMQ: $7,476.18 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
MOVAPO POD