IPILIMUMAB
|
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
2638WMP | IPILIMUMAB Injection (PI, CMI)
|
360 mg | 3 | $43490.32 | $31.60 | $31.60 |
IPILIMUMAB
|
|
|
Code & Prescriber | Name, manner of administration | Max amount | No. of repeats | DPMA | Max Safety Net | General Patient Charge | |||
---|---|---|---|---|---|---|---|---|---|
2641BMP | IPILIMUMAB Injection (PI, CMI)
|
360 mg | 3 | $42847.09 | $31.60 | $31.60 |
- Legend
- MPMedical Practitioner