VALGANCICLOVIR

valganciclovir 50 mg/mL powder for oral liquid, 100 mL

VALGANCICLOVIR (9655E)

valganciclovir 50 mg/mL powder for oral liquid, 100 mL
9655E
Body System:
Manner of administration:Oral
Public
S100 HSD Public
Authority Required (STREAMLINED)

Restriction  15800

Indication: Cytomegalovirus infection and disease

Restriction  15814

Indication: Cytomegalovirus infection and disease
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 11 Max qty units: 11 # of repeats: 5 DPMQ: $4,346.10 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Valcyte