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 |
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| 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 | $31.60 | $31.60 |
| Available brands | |||||||
| Evrysdi |
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 |
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| 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 | $10890.26 | $31.60 | $31.60 |
| Available brands | |||||||
| Evrysdi |
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 |
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| 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 | $10890.26 | $31.60 | $31.60 |
| Available brands | |||||||
| Evrysdi |
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 |
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| 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 | $31.60 | $31.60 |
| Available brands | |||||||
| Evrysdi |
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 |
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| 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 | $31.60 | $31.60 |
| Available brands | |||||||
| Evrysdi |
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 |
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| 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 | $10890.26 | $31.60 | $31.60 |
| Available brands | |||||||
| Evrysdi |
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 |
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| 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 |
|---|---|---|---|---|---|---|---|
| 13631KMP | RISDIPLAM risdiplam 750 microgram/mL powder for oral liquid, 80 mL (PI, CMI) |
3 | 3 | 5 | $32525.67 | $31.60 | $31.60 |
| Available brands | |||||||
| Evrysdi |
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 |
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| 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 |
|---|---|---|---|---|---|---|---|
| 13632LMP | RISDIPLAM risdiplam 750 microgram/mL powder for oral liquid, 80 mL (PI, CMI) |
3 | 3 | 7 | $32574.03 | $31.60 | $31.60 |
| Available brands | |||||||
| Evrysdi |
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 |
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| 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 |
|---|---|---|---|---|---|---|---|
| 13633MMP | RISDIPLAM risdiplam 750 microgram/mL powder for oral liquid, 80 mL (PI, CMI) |
3 | 3 | 5 | $32525.67 | $31.60 | $31.60 |
| Available brands | |||||||
| Evrysdi |
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 |
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| 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 |
|---|---|---|---|---|---|---|---|
| 13639WMP | RISDIPLAM risdiplam 750 microgram/mL powder for oral liquid, 80 mL (PI, CMI) |
3 | 3 | 5 | $32574.03 | $31.60 | $31.60 |
| Available brands | |||||||
| Evrysdi |
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 |
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| 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 |
|---|---|---|---|---|---|---|---|
| 13646FMP | RISDIPLAM risdiplam 750 microgram/mL powder for oral liquid, 80 mL (PI, CMI) |
3 | 3 | 5 | $32574.03 | $31.60 | $31.60 |
| Available brands | |||||||
| Evrysdi |
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 |
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| 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 |
|---|---|---|---|---|---|---|---|
| 13647GMP | RISDIPLAM risdiplam 750 microgram/mL powder for oral liquid, 80 mL (PI, CMI) |
1 | 1 | 0 | $10890.26 | $31.60 | $31.60 |
| Available brands | |||||||
| Evrysdi |
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 |
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| 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 |
|---|---|---|---|---|---|---|---|
| 13654PMP | RISDIPLAM risdiplam 750 microgram/mL powder for oral liquid, 80 mL (PI, CMI) |
3 | 3 | 7 | $32525.67 | $31.60 | $31.60 |
| Available brands | |||||||
| Evrysdi |
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 |
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| 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 |
|---|---|---|---|---|---|---|---|
| 13655QMP | RISDIPLAM risdiplam 750 microgram/mL powder for oral liquid, 80 mL (PI, CMI) |
1 | 1 | 0 | $10841.89 | $31.60 | $31.60 |
| Available brands | |||||||
| Evrysdi |
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 |
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| 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 |
|---|---|---|---|---|---|---|---|
| 13656RMP | RISDIPLAM risdiplam 750 microgram/mL powder for oral liquid, 80 mL (PI, CMI) |
3 | 3 | 5 | $32525.67 | $31.60 | $31.60 |
| Available brands | |||||||
| Evrysdi |
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 |
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| 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 |
|---|---|---|---|---|---|---|---|
| 13659XMP | RISDIPLAM risdiplam 750 microgram/mL powder for oral liquid, 80 mL (PI, CMI) |
3 | 3 | 5 | $32574.03 | $31.60 | $31.60 |
| Available brands | |||||||
| Evrysdi |
- Legend
- MPMedical Practitioner
