PEMBROLIZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
---|---|---|---|---|---|---|---|---|
10424PMP | PEMBROLIZUMAB Injection (PI, CMI)
|
200 mg | 7 | $7889.36 | $31.60 | $31.60 |
PEMBROLIZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
---|---|---|---|---|---|---|---|---|
10436GMP | PEMBROLIZUMAB Injection (PI, CMI)
|
200 mg | 7 | $7737.63 | $31.60 | $31.60 |
PEMBROLIZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
---|---|---|---|---|---|---|---|---|
10475HMP | PEMBROLIZUMAB Injection (PI, CMI)
|
200 mg | 5 | $7889.36 | $31.60 | $31.60 |
PEMBROLIZUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | ||
---|---|---|---|---|---|---|---|---|
10493GMP | PEMBROLIZUMAB Injection (PI, CMI)
|
200 mg | 5 | $7737.63 | $31.60 | $31.60 |
- Legend
- MPMedical Practitioner