VIGABATRIN
Body System:
Manner of administration:Oral
Restriction (Streamlined authority code: 17444)
Indication: Focal onset seizures
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 120 | # of repeats: 5 | DPMQ: $109.30 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Sabril | |||||
Body System:
Manner of administration:Oral
Restriction (Streamlined authority code: 17445)
Indication: Focal onset seizures
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 60 | # of repeats: 5 | DPMQ: $61.54 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Sabril | |||||
