DOXORUBICIN HYDROCHLORIDE (AS PEGYLATED LIPOSOMAL)
doxorubicin hydrochloride (as pegylated liposomal) 20 mg/10 mL injection, 10 mL vial
DOXORUBICIN HYDROCHLORIDE (AS PEGYLATED LIPOSOMAL) (6249X)
6249X
Manner of administration:Injection
Restriction (Streamlined authority code: 9287)
Indication: Kaposi sarcoma
Restriction (Streamlined authority code: 9223)
Indication: Kaposi sarcoma
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 4 | Max qty units: 4 | # of repeats: 5 | DPMQ: $584.72 | Max safety net: $25.00 | General Patient Charge: $25.00 |
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