INFLIXIMAB

infliximab 120 mg/mL injection, 1 mL syringe

INFLIXIMAB (12552P)

infliximab 120 mg/mL injection, 1 mL syringe
12552P
Body System:
Manner of administration:Injection
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17434)

Indication: Moderate to severe ulcerative colitis
Treatment phase: Continuing treatment with subcutaneous form or switching from intravenous form to subcutaneous form
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 2 # of repeats: 5 DPMQ: $760.24 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Remsima SC