TRASTUZUMAB EMTANSINE
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
10281DMP | TRASTUZUMAB EMTANSINE Injection (PI, CMI)
|
450 mg | 8 | $7415.30 | $31.60 | $31.60 |
TRASTUZUMAB EMTANSINE
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
10282EMP | TRASTUZUMAB EMTANSINE Injection (PI, CMI)
|
450 mg | 8 | $7270.12 | $31.60 | $31.60 |
TRASTUZUMAB EMTANSINE
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
11951BMP | TRASTUZUMAB EMTANSINE Injection (PI, CMI)
|
450 mg | 6 | $7270.12 | $31.60 | $31.60 |
TRASTUZUMAB EMTANSINE
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
11956GMP | TRASTUZUMAB EMTANSINE Injection (PI, CMI)
|
450 mg | 6 | $7415.30 | $31.60 | $31.60 |
- Legend
- MPMedical Practitioner