FOLLITROPIN ALFA
follitropin alfa 450 units (33 microgram)/0.75 mL injection, 5 x 0.75 mL pen devices
Manner of administration:Injection
Restriction (Streamlined authority code: 5027)
Indication: Assisted Reproductive Technology
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 3 | Max qty units: 15 | # of repeats: 0 | DPMQ: $1,896.09 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Bemfola | |||||