ELRANATAMAB

ELRANATAMAB (15293X)

Elranatamab 76 mg/1.9 mL injection, 1.9 mL vial
15293X
Body System:
Manner of administration:Injection
General Schedule
Authority Required

Restriction

Indication: Relapsed or refractory multiple myeloma
Treatment phase: Continuing treatment
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: 5 DPMQ: $6,200.93 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Elrexfio

ELRANATAMAB (15331X)

Elranatamab 76 mg/1.9 mL injection, 1.9 mL vial
15331X
Body System:
Manner of administration:Injection
Section 100 (CT)
Authority Required

Restriction

Indication: Relapsed or refractory multiple myeloma
Treatment phase: Continuing treatment
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: 5 DPMQ: $6,038.00 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Elrexfio