PEGINTERFERON ALFA-2A
peginterferon alfa-2a 135 microgram/0.5 mL injection, 4 x 0.5 mL syringes
PEGINTERFERON ALFA-2A (6439X)
6439X
Body System:
Manner of administration:Injection
Restriction 17108
Indication: Chronic hepatitis C infection
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 8 | # of repeats: 5 | DPMQ: $1,706.16 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
|
|
|||||