OMALIZUMAB
Omalizumab 75 mg/0.5 mL injection, 0.5 mL pen device
OMALIZUMAB (15537R)
15537R
Manner of administration:Injection
Restriction (Streamlined authority code: 19135)
Indication: Uncontrolled severe asthma
Treatment phase: Continuing treatment
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: 5 | DPMQ: $116.35 | Max safety net: $25.00 | General Patient Charge: $25.00 |
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