HYALURONATE SODIUM
Body System:
Manner of administration:Application To The Eye
Restriction (Streamlined authority code: 15559)
Indication: Severe dry eye syndrome
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: 5 | DPMQ: $56.50 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Hylo-Forte | |||||