OBINUTUZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
---|---|---|---|---|---|---|---|---|
10407RMP | OBINUTUZUMAB Injection (PI, CMI)
|
1000 mg | 7 | $4615.65 | $31.60 | $31.60 |
OBINUTUZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
---|---|---|---|---|---|---|---|---|
10418HMP | OBINUTUZUMAB Injection (PI, CMI)
|
1000 mg | 7 | $4723.68 | $31.60 | $31.60 |
OBINUTUZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
---|---|---|---|---|---|---|---|---|
11455XMP | OBINUTUZUMAB Injection (PI, CMI)
|
1000 mg | 5 | $4723.68 | $31.60 | $31.60 |
OBINUTUZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
---|---|---|---|---|---|---|---|---|
11456YMP | OBINUTUZUMAB Injection (PI, CMI)
|
1000 mg | 9 | $4723.68 | $31.60 | $31.60 |
OBINUTUZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
---|---|---|---|---|---|---|---|---|
11457BMP | OBINUTUZUMAB Injection (PI, CMI)
|
1000 mg | 7 | $4615.65 | $31.60 | $31.60 |
OBINUTUZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
---|---|---|---|---|---|---|---|---|
11458CMP | OBINUTUZUMAB Injection (PI, CMI)
|
1000 mg | 9 | $4615.65 | $31.60 | $31.60 |
OBINUTUZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
---|---|---|---|---|---|---|---|---|
11460EMP | OBINUTUZUMAB Injection (PI, CMI)
|
1000 mg | 7 | $4723.68 | $31.60 | $31.60 |
OBINUTUZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
---|---|---|---|---|---|---|---|---|
11462GMP | OBINUTUZUMAB Injection (PI, CMI)
|
1000 mg | 5 | $4615.65 | $31.60 | $31.60 |
OBINUTUZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
---|---|---|---|---|---|---|---|---|
11468NMP | OBINUTUZUMAB Injection (PI, CMI)
|
1000 mg | 5 | $4615.65 | $31.60 | $31.60 |
OBINUTUZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
---|---|---|---|---|---|---|---|---|
11473WMP | OBINUTUZUMAB Injection (PI, CMI)
|
1000 mg | 5 | $4723.68 | $31.60 | $31.60 |
OBINUTUZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
---|---|---|---|---|---|---|---|---|
12193RMP | OBINUTUZUMAB Injection (PI, CMI)
|
1000 mg | 8 | $4723.68 | $31.60 | $31.60 |
OBINUTUZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
---|---|---|---|---|---|---|---|---|
12204HMP | OBINUTUZUMAB Injection (PI, CMI)
|
1000 mg | 8 | $4615.65 | $31.60 | $31.60 |
OBINUTUZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
---|---|---|---|---|---|---|---|---|
13787PMP | OBINUTUZUMAB Injection (PI, CMI)
|
1000 mg | 7 | $4615.65 | $31.60 | $31.60 |
OBINUTUZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
---|---|---|---|---|---|---|---|---|
13793YMP | OBINUTUZUMAB Injection (PI, CMI)
|
1000 mg | 7 | $4723.68 | $31.60 | $31.60 |
- Legend
- MPMedical Practitioner