INSULIN LISPRO + INSULIN LISPRO PROTAMINE
insulin lispro 25 units/mL + insulin lispro protamine 75 units/mL injection, 5 x 3
mL pen devices
Body System:
Manner of administration:Injection
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 5 | Max qty units: 5 | # of repeats: 1 | DPMQ: $167.88 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Humalog Mix25 KwikPen | |||||
insulin lispro 50 units/mL + insulin lispro protamine 50 units/mL injection, 5 x 3
mL pen devices
Body System:
Manner of administration:Injection
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 5 | Max qty units: 5 | # of repeats: 1 | DPMQ: $167.88 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Humalog Mix50 KwikPen | |||||
insulin lispro 25 units/mL + insulin lispro protamine 75 units/mL injection, 5 x 3
mL cartridges
Body System:
Manner of administration:Injection
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 5 | Max qty units: 5 | # of repeats: 1 | DPMQ: $167.88 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Humalog Mix25 | |||||
insulin lispro 50 units/mL + insulin lispro protamine 50 units/mL injection, 5 x 3
mL cartridges
Body System:
Manner of administration:Injection
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 5 | Max qty units: 5 | # of repeats: 1 | DPMQ: $167.88 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Humalog Mix50 | |||||