FOLLITROPIN ALFA

follitropin alfa 225 units (16.5 microgram)/0.375 mL injection, 5 x 0.375 mL pen devices

FOLLITROPIN ALFA (10872F)

follitropin alfa 225 units (16.5 microgram)/0.375 mL injection, 5 x 0.375 mL pen devices
10872F
Body System:
Manner of administration:Injection
S100 IVF
Authority Required (STREAMLINED)

Restriction  5027

Indication: Assisted Reproductive Technology
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 3 Max qty units: 15 # of repeats: 0 DPMQ: $969.42 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Bemfola