FOLLITROPIN ALFA + LUTROPIN ALFA

follitropin alfa 900 units (65.52 microgram)/1.44 mL + lutropin alfa 450 units/1.44 mL injection, 1.44 mL pen device

FOLLITROPIN ALFA + LUTROPIN ALFA (11667C)

follitropin alfa 900 units (65.52 microgram)/1.44 mL + lutropin alfa 450 units/1.44 mL injection, 1.44 mL pen device
11667C
Body System:
Manner of administration:Injection
S100 IVF
Authority Required (STREAMLINED)

Restriction  16362

Indication: Stimulation of follicular development
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 4 Max qty units: 4 # of repeats: 0 DPMQ: $3,599.12 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Pergoveris