SACITUZUMAB GOVITECAN
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| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 12944GMP | SACITUZUMAB GOVITECAN Injection (PI, CMI)
|
1200 mg | 7 | $10674.49 | $31.60 | $31.60 |
SACITUZUMAB GOVITECAN
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|
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| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 12945HMP | SACITUZUMAB GOVITECAN Injection (PI, CMI)
|
1200 mg | 13 | $10483.36 | $31.60 | $31.60 |
SACITUZUMAB GOVITECAN
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|
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|
| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 12965JMP | SACITUZUMAB GOVITECAN Injection (PI, CMI)
|
1200 mg | 13 | $10674.49 | $31.60 | $31.60 |
SACITUZUMAB GOVITECAN
|
|
|
|
|
|
| Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
|---|---|---|---|---|---|---|---|---|
| 12966KMP | SACITUZUMAB GOVITECAN Injection (PI, CMI)
|
1200 mg | 7 | $10483.36 | $31.60 | $31.60 |
- Legend
- MPMedical Practitioner




