Hospital Medicines List

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1 results showing for: 'dimethyl fumarate'

  • Restricted. Cap 120 mg
    • Brand Tecfidera
    • Pharmacode2493004
    • Price $520.00
    • Measure / Qty per 14
  • Restricted. Cap 240 mg
    • Brand Tecfidera
    • Pharmacode2493012
    • Price $2000.00
    • Measure / Qty per 56

Note: Treatment on two or more funded multiple sclerosis treatments simultaneously is not permitted.

RS1993 - Multiple Sclerosis
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  • Restriction. Restriction
  • HSS Hospital Supply Status
  • PSS Principal Supply Status
  • dv DV Limit Gives the maximum volume that can be purchased of other brands