PEGVISOMANT
pegvisomant 20 mg injection [1 vial] (&) inert substance diluent [1 syringe], 1 pack
Manner of administration:Injection
Restriction
Indication: Acromegaly
Treatment phase: Initial treatment
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 4 | Max qty units: 4 | # of repeats: 0 | DPMQ: $559.36 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Somavert | |||||
pegvisomant 20 mg injection [1 vial] (&) inert substance diluent [1 syringe], 1 pack
Manner of administration:Injection
Restriction
Indication: Acromegaly
Treatment phase: Initial treatment
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 4 | Max qty units: 4 | # of repeats: 0 | DPMQ: $529.32 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Somavert | |||||