Source	Chemotherapy Items for Public Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > OTHER ANTINEOPLASTIC AGENTS

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
10691QMP	ARSENIC Injection (PI, CMI) Available brands Arsenic Trioxide Accord (arsenic trioxide 10 mg/10 mL injection, 10 x 10 mL vials) Arsenic Trioxide Juno (arsenic trioxide 10 mg/10 mL injection, 10 x 10 mL vials) Arsenic Trioxide-AFT (arsenic trioxide 10 mg/10 mL injection, 10 x 10 mL ampoules) Phenasen (arsenic trioxide 10 mg/10 mL injection, 10 x 10 mL vials)	18 mg	140	$205.54	$31.60	$31.60

Source	Chemotherapy Items for Private Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > OTHER ANTINEOPLASTIC AGENTS

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
10699DMP	ARSENIC Injection (PI, CMI) Available brands Arsenic Trioxide Accord (arsenic trioxide 10 mg/10 mL injection, 10 x 10 mL vials) Arsenic Trioxide Juno (arsenic trioxide 10 mg/10 mL injection, 10 x 10 mL vials) Arsenic Trioxide-AFT (arsenic trioxide 10 mg/10 mL injection, 10 x 10 mL ampoules) Phenasen (arsenic trioxide 10 mg/10 mL injection, 10 x 10 mL vials)	18 mg	140	$250.47	$31.60	$31.60

Source	Chemotherapy Items for Public Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > OTHER ANTINEOPLASTIC AGENTS

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
4371CMP	ARSENIC Injection (PI, CMI) Available brands Arsenic Trioxide Accord (arsenic trioxide 10 mg/10 mL injection, 10 x 10 mL vials) Arsenic Trioxide Juno (arsenic trioxide 10 mg/10 mL injection, 10 x 10 mL vials) Arsenic Trioxide-AFT (arsenic trioxide 10 mg/10 mL injection, 10 x 10 mL ampoules) Phenasen (arsenic trioxide 10 mg/10 mL injection, 10 x 10 mL vials)	18 mg	89	$205.54	$31.60	$31.60

Source	Chemotherapy Items for Private Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > OTHER ANTINEOPLASTIC AGENTS

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
7241DMP	ARSENIC Injection (PI, CMI) Available brands Arsenic Trioxide Accord (arsenic trioxide 10 mg/10 mL injection, 10 x 10 mL vials) Arsenic Trioxide Juno (arsenic trioxide 10 mg/10 mL injection, 10 x 10 mL vials) Arsenic Trioxide-AFT (arsenic trioxide 10 mg/10 mL injection, 10 x 10 mL ampoules) Phenasen (arsenic trioxide 10 mg/10 mL injection, 10 x 10 mL vials)	18 mg	89	$250.47	$31.60	$31.60