TRASTUZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
10383LMP | TRASTUZUMAB Injection (PI, CMI)
|
750 mg | 3 | $686.45 | $31.60 | $31.60 |
TRASTUZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
10402LMP | TRASTUZUMAB Injection (PI, CMI)
|
1000 mg | 0 | $857.19 | $31.60 | $31.60 |
TRASTUZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
10589HMP | TRASTUZUMAB Injection (PI, CMI)
|
1000 mg | 0 | $857.19 | $31.60 | $31.60 |
TRASTUZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
10597RMP | TRASTUZUMAB Injection (PI, CMI)
|
750 mg | 3 | $686.45 | $31.60 | $31.60 |
TRASTUZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
7264HMP | TRASTUZUMAB Injection (PI, CMI)
|
500 mg | 0 | $481.69 | $31.60 | $31.60 |
TRASTUZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
7265JMP | TRASTUZUMAB Injection (PI, CMI)
|
250 mg | 9 | $333.13 | $31.60 | $31.60 |
TRASTUZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
7266KMP | TRASTUZUMAB Injection (PI, CMI)
|
1000 mg | 0 | $857.19 | $31.60 | $31.60 |
TRASTUZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
7267LMP | TRASTUZUMAB Injection (PI, CMI)
|
750 mg | 3 | $686.45 | $31.60 | $31.60 |
- Legend
- MPMedical Practitioner