ENFORTUMAB VEDOTIN
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
13634NMP | ENFORTUMAB VEDOTIN Injection (PI, CMI)
|
125 mg | 8 | $6343.91 | $31.60 | $31.60 |
ENFORTUMAB VEDOTIN
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
13648HMP | ENFORTUMAB VEDOTIN Injection (PI, CMI)
|
125 mg | 8 | $6213.52 | $31.60 | $31.60 |
- Legend
- MPMedical Practitioner