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 |
|---|---|---|---|---|---|---|---|
| 15273WMP | RISDIPLAM risdiplam 5 mg tablet, 28 (PI, CMI) |
1 | 28 | 5 | $25,297.74 | $25.00 | $25.00 |
| 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 |
|---|---|---|---|---|---|---|---|
| 15274XMP | RISDIPLAM risdiplam 5 mg tablet, 28 (PI, CMI) |
1 | 28 | 5 | $25,346.62 | $25.00 | $25.00 |
| 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 |
|---|---|---|---|---|---|---|---|
| 15275YMP | RISDIPLAM risdiplam 5 mg tablet, 28 (PI, CMI) |
1 | 28 | 5 | $25,297.74 | $25.00 | $25.00 |
| 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 |
|---|---|---|---|---|---|---|---|
| 15281GMP | RISDIPLAM risdiplam 5 mg tablet, 28 (PI, CMI) |
1 | 28 | 5 | $25,297.74 | $25.00 | $25.00 |
| 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 |
|---|---|---|---|---|---|---|---|
| 15290RMP | RISDIPLAM risdiplam 5 mg tablet, 28 (PI, CMI) |
1 | 28 | 5 | $25,346.62 | $25.00 | $25.00 |
| 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 |
|---|---|---|---|---|---|---|---|
| 15296CMP | RISDIPLAM risdiplam 5 mg tablet, 28 (PI, CMI) |
1 | 28 | 5 | $25,346.62 | $25.00 | $25.00 |
| 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 |
|---|---|---|---|---|---|---|---|
| 15297DMP | RISDIPLAM risdiplam 5 mg tablet, 28 (PI, CMI) |
1 | 28 | 5 | $25,297.74 | $25.00 | $25.00 |
| 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 |
|---|---|---|---|---|---|---|---|
| 15298EMP | RISDIPLAM risdiplam 5 mg tablet, 28 (PI, CMI) |
1 | 28 | 5 | $25,346.62 | $25.00 | $25.00 |
| 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 |
|---|---|---|---|---|---|---|---|
| 15308QMP | RISDIPLAM risdiplam 5 mg tablet, 28 (PI, CMI) |
1 | 28 | 5 | $25,346.62 | $25.00 | $25.00 |
| 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 |
|---|---|---|---|---|---|---|---|
| 15309RMP | RISDIPLAM risdiplam 5 mg tablet, 28 (PI, CMI) |
1 | 28 | 5 | $25,297.74 | $25.00 | $25.00 |
| 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 |
|---|---|---|---|---|---|---|---|
| 15310TMP | RISDIPLAM risdiplam 5 mg tablet, 28 (PI, CMI) |
1 | 28 | 5 | $25,297.74 | $25.00 | $25.00 |
| 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 |
|---|---|---|---|---|---|---|---|
| 15321JMP | RISDIPLAM risdiplam 5 mg tablet, 28 (PI, CMI) |
1 | 28 | 5 | $25,346.62 | $25.00 | $25.00 |
| 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 |
|---|---|---|---|---|---|---|---|
| 15327QMP | RISDIPLAM risdiplam 5 mg tablet, 28 (PI, CMI) |
1 | 28 | 5 | $25,297.74 | $25.00 | $25.00 |
| 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 |
|---|---|---|---|---|---|---|---|
| 15328RMP | RISDIPLAM risdiplam 5 mg tablet, 28 (PI, CMI) |
1 | 28 | 5 | $25,346.62 | $25.00 | $25.00 |
| Available brands | |||||||
| Evrysdi |
- Legend
- MPMedical Practitioner
