INCOBOTULINUMTOXINA

incobotulinumtoxinA 100 units injection, 1 vial

INCOBOTULINUMTOXINA (15247L)

incobotulinumtoxinA 100 units injection, 1 vial
15247L
Manner of administration:Injection
S100 Botulinum Toxin Program
Authority Required (STREAMLINED)

Restriction  18059

Indication: Chronic sialorrhea
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 0 DPMQ: $339.29 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Xeomin