MYCOBACTERIUM BOVIS BCG DANISH STRAIN

Mycobacterium bovis BCG Danish strain 30 mg injection, 4 vials

MYCOBACTERIUM BOVIS BCG DANISH STRAIN (12925G)

Mycobacterium bovis BCG Danish strain 30 mg injection, 4 vials
12925G
Manner of administration:Intravesical
Section 100 (CT)
Restricted Benefit

Restriction

Indication: Primary and relapsing superficial urothelial carcinoma of the bladder
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 3 Max qty units: 3 # of repeats: 1 DPMQ: $1,650.00 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
VesiCulture