PEGINTERFERON BETA-1A
peginterferon beta-1a 125 microgram/0.5 mL injection, 2 x 0.5 mL pen devices
Body System:
Manner of administration:Injection
Restriction (Streamlined authority code: 16321)
Indication: Multiple sclerosis
Treatment phase: Initial treatment
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 2 | # of repeats: 4 | DPMQ: $635.89 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Plegridy | |||||
peginterferon beta-1a 125 microgram/0.5 mL injection, 2 x 0.5 mL pen devices
Body System:
Manner of administration:Injection
Restriction (Streamlined authority code: 16297)
Indication: Multiple sclerosis
Treatment phase: Continuing treatment
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 2 | # of repeats: 5 | DPMQ: $635.89 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Plegridy | |||||