Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10137MMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL syringes (PI, CMI)	1	2	5	$1027.15	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10238WMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL syringes (PI, CMI)	1	2	5	$1027.15	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10892GMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL syringes (PI, CMI)	1	2	2	$1027.15	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10896LMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL syringes (PI, CMI)	1	2	2	$1027.15	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10897MMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL syringes (PI, CMI)	1	2	2	$1027.15	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10904XMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL syringes (PI, CMI)	3	6	0	$3018.99	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10905YMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL syringes (PI, CMI)	3	6	0	$3018.99	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10909EMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL syringes (PI, CMI)	3	6	0	$3018.99	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
11318QMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL pen devices (PI, CMI)	1	2	2	$1027.15	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
11319RMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL pen devices (PI, CMI)	3	6	0	$3018.99	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
11320TMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL pen devices (PI, CMI)	1	2	5	$1027.15	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
11321WMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL pen devices (PI, CMI)	1	2	2	$1027.15	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
11322XMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL pen devices (PI, CMI)	3	6	0	$3018.99	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
11323YMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL pen devices (PI, CMI)	3	6	0	$3018.99	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
11324BMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL pen devices (PI, CMI)	1	2	5	$1027.15	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
11325CMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL pen devices (PI, CMI)	1	2	5	$1027.15	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
11326DMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL pen devices (PI, CMI)	1	2	2	$1027.15	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
12005WMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL syringes (PI, CMI)	1	2	5	$1027.15	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
12013GMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL pen devices (PI, CMI)	1	2	0	$1027.15	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
12027BMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL pen devices (PI, CMI)	3	6	0	$3018.99	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
12028CMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL pen devices (PI, CMI)	1	2	5	$1027.15	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
12040QMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL syringes (PI, CMI)	1	2	0	$1027.15	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
12063XMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL syringes (PI, CMI)	3	6	0	$3018.99	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required (STREAMLINED)

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
13701DMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL pen devices (PI, CMI)	1	2	5	$1027.15	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required (STREAMLINED)

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
13735XMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL syringes (PI, CMI)	1	2	5	$1027.15	$31.60	$31.60
	Available brands
	Cimzia

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
3425GMP	CERTOLIZUMAB PEGOL certolizumab pegol 200 mg/mL injection, 2 x 1 mL syringes (PI, CMI)	1	2	5	$1027.15	$31.60	$31.60
	Available brands
	Cimzia