USTEKINUMAB

USTEKINUMAB (12662K)

ustekinumab 45 mg/0.5 mL injection, 0.5 mL vial
12662K
Body System:
Manner of administration:Injection
General Schedule
Authority Required

Restriction

Indication: Severe chronic plaque psoriasis
Treatment phase: First continuing, Subsequent continuing treatment - balance of supply (Whole body, or, face/hand/foot)
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 0 DPMQ: $794.25 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Stelara
Wezlana