ATEZOLIZUMAB
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| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 11277MMP | ATEZOLIZUMAB Injection (PI, CMI) 
  | 
                  1200 mg | 7 | $6838.60 | $31.60 | $31.60 | 
ATEZOLIZUMAB
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| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 11284XMP | ATEZOLIZUMAB Injection (PI, CMI) 
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                  1200 mg | 5 | $6838.60 | $31.60 | $31.60 | 
ATEZOLIZUMAB
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| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 11297NMP | ATEZOLIZUMAB Injection (PI, CMI) 
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                  1200 mg | 7 | $6978.73 | $31.60 | $31.60 | 
ATEZOLIZUMAB
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| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
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| 11309FMP | ATEZOLIZUMAB Injection (PI, CMI) 
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                  1200 mg | 5 | $6978.73 | $31.60 | $31.60 | 
ATEZOLIZUMAB
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| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 11792PMP | ATEZOLIZUMAB Injection (PI, CMI) 
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                  1200 mg | 5 | $6978.73 | $31.60 | $31.60 | 
ATEZOLIZUMAB
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| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 11801DMP | ATEZOLIZUMAB Injection (PI, CMI) 
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                  1200 mg | 7 | $6978.73 | $31.60 | $31.60 | 
ATEZOLIZUMAB
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| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 11802EMP | ATEZOLIZUMAB Injection (PI, CMI) 
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                  1200 mg | 7 | $6838.60 | $31.60 | $31.60 | 
ATEZOLIZUMAB
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| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 11807KMP | ATEZOLIZUMAB Injection (PI, CMI) 
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                  1200 mg | 5 | $6838.60 | $31.60 | $31.60 | 
ATEZOLIZUMAB
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| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 11926QMP | ATEZOLIZUMAB Injection (PI, CMI) 
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                  1200 mg | 3 | $6838.60 | $31.60 | $31.60 | 
ATEZOLIZUMAB
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| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 11927RMP | ATEZOLIZUMAB Injection (PI, CMI) 
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                  1200 mg | 3 | $6978.73 | $31.60 | $31.60 | 
ATEZOLIZUMAB
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| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 11928TMP | ATEZOLIZUMAB Injection (PI, CMI) 
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                  1200 mg | 4 | $6978.73 | $31.60 | $31.60 | 
ATEZOLIZUMAB
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| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 11929WMP | ATEZOLIZUMAB Injection (PI, CMI) 
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                  1200 mg | 4 | $6838.60 | $31.60 | $31.60 | 
ATEZOLIZUMAB
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| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 12155RMP | ATEZOLIZUMAB Injection (PI, CMI) 
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                  1200 mg | 8 | $6978.73 | $31.60 | $31.60 | 
ATEZOLIZUMAB
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| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 12167JMP | ATEZOLIZUMAB Injection (PI, CMI) 
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                  1200 mg | 3 | $6978.73 | $31.60 | $31.60 | 
ATEZOLIZUMAB
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| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 12168KMP | ATEZOLIZUMAB Injection (PI, CMI) 
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                  1200 mg | 8 | $6838.60 | $31.60 | $31.60 | 
ATEZOLIZUMAB
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| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 12171NMP | ATEZOLIZUMAB Injection (PI, CMI) 
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                  1200 mg | 3 | $6838.60 | $31.60 | $31.60 | 
ATEZOLIZUMAB
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| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 13172GMP | ATEZOLIZUMAB Injection (PI, CMI) 
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                  1200 mg | 7 | $6978.73 | $31.60 | $31.60 | 
ATEZOLIZUMAB
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| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 13174JMP | ATEZOLIZUMAB Injection (PI, CMI) 
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                  1200 mg | 7 | $6838.60 | $31.60 | $31.60 | 
- Legend
 - MPMedical Practitioner
 




