TRASTUZUMAB EMTANSINE
|  | 
|  | 
| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
|---|---|---|---|---|---|---|---|---|---|
| 10281DMP | TRASTUZUMAB EMTANSINE Injection (PI, CMI) 
 | 450 mg | 8 | $7417.40 | $31.60 | $31.60 | 
TRASTUZUMAB EMTANSINE
|  | 
|  | 
| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
|---|---|---|---|---|---|---|---|---|---|
| 10282EMP | TRASTUZUMAB EMTANSINE Injection (PI, CMI) 
 | 450 mg | 8 | $7271.22 | $31.60 | $31.60 | 
TRASTUZUMAB EMTANSINE
|  | 
|  | 
| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
|---|---|---|---|---|---|---|---|---|---|
| 11951BMP | TRASTUZUMAB EMTANSINE Injection (PI, CMI) 
 | 450 mg | 6 | $7271.22 | $31.60 | $31.60 | 
TRASTUZUMAB EMTANSINE
|  | 
|  | 
| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
|---|---|---|---|---|---|---|---|---|---|
| 11956GMP | TRASTUZUMAB EMTANSINE Injection (PI, CMI) 
 | 450 mg | 6 | $7417.40 | $31.60 | $31.60 | 
- Legend
- MPMedical Practitioner




