FOLLITROPIN DELTA

follitropin delta 72 microgram/2.16 mL injection, 2.16 mL pen device

FOLLITROPIN DELTA (11414R)

follitropin delta 72 microgram/2.16 mL injection, 2.16 mL pen device
11414R
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: 4 Max qty units: 4 # of repeats: 0 DPMQ: $2,065.52 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Rekovelle