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 | $727.88 | $30.00 | $30.00 |
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 | $945.39 | $30.00 | $30.00 |
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 | $945.39 | $30.00 | $30.00 |
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 | $727.88 | $30.00 | $30.00 |
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 | $535.32 | $30.00 | $30.00 |
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 | $351.44 | $30.00 | $30.00 |
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 | $945.39 | $30.00 | $30.00 |
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 | $727.88 | $30.00 | $30.00 |
- Legend
- MPMedical Practitioner