UBLITUXIMAB
Manner of administration:Injection
Restriction (Streamlined authority code: 7386)
Indication: Multiple sclerosis
Treatment phase: Continuing treatment
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: $11,583.00 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Briumvi | |||||
Manner of administration:Injection
Restriction (Streamlined authority code: 7699)
Indication: Multiple sclerosis
Treatment phase: Initial treatment
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 4 | Max qty units: 4 | # of repeats: 0 | DPMQ: $15,444.00 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Briumvi | |||||
Manner of administration:Injection
Restriction (Streamlined authority code: 9523)
Indication: Multiple sclerosis
Treatment phase: Initial treatment
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 4 | Max qty units: 4 | # of repeats: 0 | DPMQ: $15,492.88 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Briumvi | |||||
Manner of administration:Injection
Restriction (Streamlined authority code: 9635)
Indication: Multiple sclerosis
Treatment phase: Continuing treatment
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: $11,631.87 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Briumvi | |||||