BLEOMYCIN

bleomycin sulfate 15 000 international units injection, 1 vial

BLEOMYCIN (7244G)

bleomycin sulfate 15 000 international units injection, 1 vial
7244G
Body System:
Manner of administration:Injection
Private
Chemotherapy Items for Private Hospital use
Restricted Benefit

Restriction

Indication: Germ cell neoplasms

Restriction

Indication: Lymphoma
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 30000 iu # of repeats: 11 DPMA: $225.50 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
DBL Bleomycin Sulfate
(bleomycin sulfate 15 000 international units injection, 1 vial)