DESMOPRESSIN
desmopressin 120 microgram sublingual wafer, 30
DESMOPRESSIN (14004C)
14004C
Manner of administration:Sublingual
Restriction 14972
Indication: Primary nocturnal enuresis
Restriction 14842
Indication: Primary nocturnal enuresis
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 60 | # of repeats: 5 | DPMQ: $87.82 | Max safety net: $25.00 | General Patient Charge: $25.00 |
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