PEGINTERFERON ALFA-2A
peginterferon alfa-2a 135 microgram/0.5 mL injection, 4 x 0.5 mL syringes
PEGINTERFERON ALFA-2A (9515T)
9515T
Body System:
Manner of administration:Injection
Restriction (Streamlined authority code: 17022)
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: $1,657.28 | Max safety net: $25.00 | General Patient Charge: $25.00 |
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