TEMOZOLOMIDE
Manner of administration:Oral
Restriction
Indication: Glioblastoma multiforme
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 3 | Max qty units: 15 | # of repeats: 2 | DPMQ: $336.93 | Max safety net: $25.00 | General Patient Charge: $25.00 |
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Manner of administration:Oral
Restriction
Indication: For prescribing by certain health practitioners
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 5 | # of repeats: 5 | DPMQ: $118.55 | Max safety net: $25.00 | General Patient Charge: $25.00 |
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Manner of administration:Oral
Restriction
Indication: For prescribing by certain health practitioners
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 5 | # of repeats: 5 | DPMQ: $19.34 | Max safety net: $20.88 | General Patient Charge: $23.67 |
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Manner of administration:Oral
Restriction
Indication: For prescribing by certain health practitioners
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 5 | # of repeats: 5 | DPMQ: $26.08 | Max safety net: $25.00 | General Patient Charge: $25.00 |
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Manner of administration:Oral
Restriction
Indication: For prescribing by certain health practitioners
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 5 | # of repeats: 5 | DPMQ: $64.62 | Max safety net: $25.00 | General Patient Charge: $25.00 |
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Manner of administration:Oral
Restriction
Indication: For prescribing by certain health practitioners
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 5 | # of repeats: 5 | DPMQ: $134.74 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
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Manner of administration:Oral
Restriction
Indication: Glioblastoma multiforme
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 3 | Max qty units: 15 | # of repeats: 2 | DPMQ: $29.31 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
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Manner of administration:Oral
Restriction
Indication: Glioblastoma multiforme
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 3 | Max qty units: 15 | # of repeats: 2 | DPMQ: $49.53 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
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Manner of administration:Oral
Restriction
Indication: Glioblastoma multiforme
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 3 | Max qty units: 15 | # of repeats: 2 | DPMQ: $167.67 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
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Manner of administration:Oral
Restriction
Indication: Glioblastoma multiforme
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 3 | Max qty units: 15 | # of repeats: 2 | DPMQ: $227.73 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
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