RITUXIMAB

RITUXIMAB (13082M)

rituximab 100 mg/10 mL injection, 2 x 10 mL vials
13082M
Body System:
Manner of administration:Injection
Public
S100 HSD Public
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: 6 # of repeats: 0 DPMQ: $259.44 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Riximyo
Truxima

RITUXIMAB (13088W)

rituximab 100 mg/10 mL injection, 10 mL vial
13088W
Body System:
Manner of administration:Injection
Public
S100 HSD Public
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 6 Max qty units: 6 # of repeats: 0 DPMQ: $259.44 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Ruxience

RITUXIMAB (13090Y)

13090Y
Body System:
Manner of administration:Injection
Private
Chemotherapy Items for Private Hospital use
No restrictions
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 800 mg # of repeats: 11 DPMA: $487.66 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Riximyo
(rituximab 100 mg/10 mL injection, 2 x 10 mL vials)
Riximyo
(rituximab 500 mg/50 mL injection, 50 mL vial)
Ruxience
(rituximab 100 mg/10 mL injection, 10 mL vial)
Ruxience
(rituximab 500 mg/50 mL injection, 50 mL vial)
Truxima
(rituximab 100 mg/10 mL injection, 2 x 10 mL vials)
Truxima
(rituximab 500 mg/50 mL injection, 50 mL vial)

RITUXIMAB (13095F)

rituximab 500 mg/50 mL injection, 50 mL vial
13095F
Body System:
Manner of administration:Injection
Private
S100 HSD Private
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 2 # of repeats: 1 DPMQ: $458.54 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Riximyo
Ruxience
Truxima

RITUXIMAB (13096G)

rituximab 100 mg/10 mL injection, 2 x 10 mL vials
13096G
Body System:
Manner of administration:Injection
Private
S100 HSD Private
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: 6 # of repeats: 0 DPMQ: $278.70 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Riximyo
Truxima

RITUXIMAB (13101M)

rituximab 500 mg/50 mL injection, 50 mL vial
13101M
Body System:
Manner of administration:Injection
Public
S100 HSD Public
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 2 # of repeats: 1 DPMQ: $432.36 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Riximyo
Ruxience
Truxima

RITUXIMAB (13102N)

13102N
Body System:
Manner of administration:Injection
Public
Chemotherapy Items for Public Hospital use
No restrictions
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 800 mg # of repeats: 11 DPMA: $437.13 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Riximyo
(rituximab 100 mg/10 mL injection, 2 x 10 mL vials)
Riximyo
(rituximab 500 mg/50 mL injection, 50 mL vial)
Ruxience
(rituximab 100 mg/10 mL injection, 10 mL vial)
Ruxience
(rituximab 500 mg/50 mL injection, 50 mL vial)
Truxima
(rituximab 100 mg/10 mL injection, 2 x 10 mL vials)
Truxima
(rituximab 500 mg/50 mL injection, 50 mL vial)

RITUXIMAB (13109Y)

rituximab 100 mg/10 mL injection, 10 mL vial
13109Y
Body System:
Manner of administration:Injection
Private
S100 HSD Private
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 6 Max qty units: 6 # of repeats: 0 DPMQ: $278.70 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Ruxience