FERRIC DERISOMALTOSE

FERRIC DERISOMALTOSE (11615H)

iron (as ferric derisomaltose) 500 mg/5 mL injection, 5 mL vial
11615H
Body System:
Manner of administration:Injection
General Schedule
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 3 Max qty units: 3 # of repeats: 0 DPMQ: $424.50 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Monofer

FERRIC DERISOMALTOSE (12049E)

iron (as ferric derisomaltose) 1 g/10 mL injection, 10 mL vial
12049E
Body System:
Manner of administration:Injection
General Schedule
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 1 DPMQ: $285.93 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Monofer