TEPROTUMUMAB
Manner of administration:Injection
Restriction
Indication: Active moderate to severe thyroid eye disease
Treatment phase: Initial 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: $31,992.27 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Tepezza | |||||
Manner of administration:Injection
Restriction
Indication: Active moderate to severe thyroid eye disease
Treatment phase: Initial 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: $31,943.04 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Tepezza | |||||
Manner of administration:Injection
Restriction (Streamlined authority code: 19524)
Indication: Active moderate to severe thyroid eye disease
Treatment phase: Continuing treatment
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: 6 | DPMQ: $63,886.08 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Tepezza | |||||
Manner of administration:Injection
Restriction (Streamlined authority code: 19461)
Indication: Active moderate to severe thyroid eye disease
Treatment phase: Continuing treatment
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: 6 | DPMQ: $63,935.34 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Tepezza | |||||