METHOTREXATE

methotrexate 7.5 mg/0.15 mL injection, 0.15 mL syringe

METHOTREXATE (14091P)

methotrexate 7.5 mg/0.15 mL injection, 0.15 mL syringe
14091P
Body System:
Manner of administration:Injection
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 15068)

Indication: Severe active juvenile idiopathic arthritis
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 4 Max qty units: 4 # of repeats: 5 DPMQ: $91.20 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Trexject