RISDIPLAM

Source S100 HSD Public
Body System MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM
Code & Prescriber Medicinal Product Pack
(Name, form & strength and pack size)
Max qty packs Max qty units No. of repeats DPMQ Max Safety Net General Patient Charge
12606LMP RISDIPLAM
risdiplam 750 microgram/mL powder for oral liquid, 80 mL (PI, CMI)
1 1 5 $10841.89 $42.50 $42.50
Available brands
Evrysdi
space

RISDIPLAM

Source S100 HSD Private
Body System MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM
Code & Prescriber Medicinal Product Pack
(Name, form & strength and pack size)
Max qty packs Max qty units No. of repeats DPMQ Max Safety Net General Patient Charge
12609PMP RISDIPLAM
risdiplam 750 microgram/mL powder for oral liquid, 80 mL (PI, CMI)
1 1 5 $10889.71 $42.50 $42.50
Available brands
Evrysdi
space

RISDIPLAM

Source S100 HSD Private
Body System MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM
Code & Prescriber Medicinal Product Pack
(Name, form & strength and pack size)
Max qty packs Max qty units No. of repeats DPMQ Max Safety Net General Patient Charge
12610QMP RISDIPLAM
risdiplam 750 microgram/mL powder for oral liquid, 80 mL (PI, CMI)
1 1 0 $10889.71 $42.50 $42.50
Available brands
Evrysdi
space

RISDIPLAM

Source S100 HSD Public
Body System MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM
Code & Prescriber Medicinal Product Pack
(Name, form & strength and pack size)
Max qty packs Max qty units No. of repeats DPMQ Max Safety Net General Patient Charge
12614XMP RISDIPLAM
risdiplam 750 microgram/mL powder for oral liquid, 80 mL (PI, CMI)
1 1 0 $10841.89 $42.50 $42.50
Available brands
Evrysdi
space

RISDIPLAM

Source S100 HSD Public
Body System MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM
Code & Prescriber Medicinal Product Pack
(Name, form & strength and pack size)
Max qty packs Max qty units No. of repeats DPMQ Max Safety Net General Patient Charge
12943FMP RISDIPLAM
risdiplam 750 microgram/mL powder for oral liquid, 80 mL (PI, CMI)
1 1 0 $10841.89 $42.50 $42.50
Available brands
Evrysdi
space

RISDIPLAM

Source S100 HSD Private
Body System MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM
Code & Prescriber Medicinal Product Pack
(Name, form & strength and pack size)
Max qty packs Max qty units No. of repeats DPMQ Max Safety Net General Patient Charge
12959CMP RISDIPLAM
risdiplam 750 microgram/mL powder for oral liquid, 80 mL (PI, CMI)
1 1 0 $10889.71 $42.50 $42.50
Available brands
Evrysdi
space


  • Legend
  • MPMedical Practitioner