MESALAZINE
Manner of administration:Rectal
Restriction
Indication: Mild to moderate ulcerative proctitis
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 28 | # of repeats: 5 | DPMQ: $83.46 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Pentasa | |||||
Manner of administration:Rectal
Restriction
Indication: Mild to moderate ulcerative proctitis
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 56 | # of repeats: 5 | DPMQ: $155.10 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Pentasa | |||||