AFLIBERCEPT
aflibercept 2 mg/0.05 mL injection, 0.05 mL syringe
AFLIBERCEPT (13150D)
13150D
Body System:
Manner of administration:Injection
Restriction 13402
Indication: Diabetic macular oedema (DMO)
Treatment phase: Continuing treatment
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 1 | # of repeats: 5 | DPMQ: $313.09 | Max safety net: $25.00 | General Patient Charge: $25.00 |
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