BRIVARACETAM
Body System:
Manner of administration:Oral
Restriction (Streamlined authority code: 17452)
Indication: Intractable focal onset seizures
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: 56 | # of repeats: 5 | DPMQ: $157.62 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Briviact | |||||
Body System:
Manner of administration:Oral
Restriction (Streamlined authority code: 17451)
Indication: Intractable focal onset seizures
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: 56 | # of repeats: 5 | DPMQ: $157.62 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Briviact | |||||