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
12337HMP	ADALIMUMAB adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes (PI, CMI)	1	2	5	$649.05	$31.60	$31.60
	Available brands
	Humiraa

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
12371DMP	ADALIMUMAB adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes (PI, CMI)	1	2	3	$649.05	$31.60	$31.60
	Available brands
	Humiraa

Source	S100 HSD Public
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
12406YMP	ADALIMUMAB adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes (PI, CMI)	1	2	0	$567.42	$31.60	$31.60
	Available brands
	Humiraa

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
12407BMP	ADALIMUMAB adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes (PI, CMI)	1	2	3	$649.05	$31.60	$31.60
	Available brands
	Humiraa

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
12423WMP	ADALIMUMAB adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes (PI, CMI)	1	2	0	$649.05	$31.60	$31.60
	Available brands
	Humiraa

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
12424XMP	ADALIMUMAB adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes (PI, CMI)	1	2	5	$649.05	$31.60	$31.60
	Available brands
	Humiraa

Source	S100 HSD Private
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
12443XMP	ADALIMUMAB adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes (PI, CMI)	1	2	0	$598.79	$31.60	$31.60
	Available brands
	Humiraa

Source	S100 HSD Private
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
13292NMP	ADALIMUMAB adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes (PI, CMI)	1	2	5	$598.79	$31.60	$31.60
	Available brands
	Humiraa

Source	S100 HSD Public
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
13293PMP	ADALIMUMAB adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes (PI, CMI)	1	2	5	$567.42	$31.60	$31.60
	Available brands
	Humiraa

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
14244QMP	ADALIMUMAB adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes (PI, CMI)	1	2	6	$649.05	$31.60	$31.60
	Available brands
	Humira

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
14245RMP	ADALIMUMAB adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes (PI, CMI)	1	2	0	$649.05	$31.60	$31.60
	Available brands
	Humira

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
14275HMP	ADALIMUMAB adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes (PI, CMI)	1	2	5	$649.05	$31.60	$31.60
	Available brands
	Humira