NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
10745MMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 11 | $9559.69 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
10748QMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 11 | $9736.96 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
10764MMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 8 | $9559.69 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
10775DMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 8 | $9736.96 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
11143LMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 8 | $9736.96 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
11150WMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 8 | $9559.69 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
11152YMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 11 | $9736.96 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
11153BMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 11 | $9559.69 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
11157FMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 11 | $9736.96 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
11158GMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 8 | $9559.69 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
11159HMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 8 | $9736.96 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
11160JMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 11 | $9559.69 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
11411NMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 11 | $9559.69 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
11425HMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 11 | $9736.96 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
11434TMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 8 | $9736.96 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
11435WMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 8 | $9559.69 | $31.60 | $31.60 |
NIVOLUMAB
|
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
11532YMP | NIVOLUMAB Injection (PI, CMI)
|
120 mg | 3 | $2535.34 | $31.60 | $31.60 |
NIVOLUMAB
|
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
11543MMP | NIVOLUMAB Injection (PI, CMI)
|
120 mg | 3 | $2457.52 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
11626XMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 11 | $9736.96 | $31.60 | $31.60 |
NIVOLUMAB
|
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
11627YMP | NIVOLUMAB Injection (PI, CMI)
|
360 mg | 3 | $7336.42 | $31.60 | $31.60 |
NIVOLUMAB
|
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
11636KMP | NIVOLUMAB Injection (PI, CMI)
|
360 mg | 3 | $7192.30 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
11642RMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 11 | $9559.69 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
11900HMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 5 | $9559.69 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
11906PMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 5 | $9736.96 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
12315EMP | NIVOLUMAB Injection (PI, CMI)
|
360 mg | 13 | $7336.42 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
12323NMP | NIVOLUMAB Injection (PI, CMI)
|
360 mg | 13 | $7192.30 | $31.60 | $31.60 |
NIVOLUMAB
|
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
12574TMP | NIVOLUMAB Injection (PI, CMI)
|
360 mg | 8 | $7336.42 | $31.60 | $31.60 |
NIVOLUMAB
|
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
12602GMP | NIVOLUMAB Injection (PI, CMI)
|
360 mg | 8 | $7192.30 | $31.60 | $31.60 |
NIVOLUMAB
|
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
13117JMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 13 | $9736.96 | $31.60 | $31.60 |
NIVOLUMAB
|
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
13121NMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 13 | $9559.69 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
13240WMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 5 | $9559.69 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
13246EMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 5 | $9736.96 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
14231BMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 5 | $9559.69 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
14232CMP | NIVOLUMAB Injection (PI, CMI)
|
360 mg | 2 | $7336.42 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
14233DMP | NIVOLUMAB Injection (PI, CMI)
|
360 mg | 2 | $7192.30 | $31.60 | $31.60 |
NIVOLUMAB
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
14260MMP | NIVOLUMAB Injection (PI, CMI)
|
480 mg | 5 | $9736.96 | $31.60 | $31.60 |
- Legend
- MPMedical Practitioner