ADALIMUMAB

ADALIMUMAB (12330Y)

adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices
12330Y
Body System:
Manner of administration:Injection
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 11529)

Indication: Moderate to severe hidradenitis suppurativa
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: 2 Max qty units: 4 # of repeats: 5 DPMQ: $979.46 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Abrilada
Amgevita
Hadlima
Hyrimoz