GALANTAMINE
Body System:
Manner of administration:Oral
Restriction (Streamlined authority code: 13938)
Indication: Mild to moderately severe Alzheimer disease
Treatment phase: Continuing
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 28 | # of repeats: 5 | DPMQ: $35.67 | Max safety net: $25.00 | General Patient Charge: $25.00 |
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Body System:
Manner of administration:Oral
Restriction (Streamlined authority code: 13938)
Indication: Mild to moderately severe Alzheimer disease
Treatment phase: Continuing
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 28 | # of repeats: 5 | DPMQ: $45.68 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
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Body System:
Manner of administration:Oral
Restriction (Streamlined authority code: 13938)
Indication: Mild to moderately severe Alzheimer disease
Treatment phase: Continuing
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 28 | # of repeats: 5 | DPMQ: $40.55 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
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Body System:
Manner of administration:Oral
Restriction
Indication: Mild to moderately severe Alzheimer disease
Treatment phase: Initial
Restriction
Indication: Mild to moderately severe Alzheimer disease
Treatment phase: Initial
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 28 | # of repeats: 5 | DPMQ: $35.67 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
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Body System:
Manner of administration:Oral
Restriction
Indication: Mild to moderately severe Alzheimer disease
Treatment phase: Initial
Restriction
Indication: Mild to moderately severe Alzheimer disease
Treatment phase: Initial
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 28 | # of repeats: 5 | DPMQ: $40.55 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
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|
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|
|||||
Body System:
Manner of administration:Oral
Restriction
Indication: Mild to moderately severe Alzheimer disease
Treatment phase: Initial
Restriction
Indication: Mild to moderately severe Alzheimer disease
Treatment phase: Initial
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 28 | # of repeats: 5 | DPMQ: $45.68 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
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