TOBRAMYCIN

TOBRAMYCIN (10066T)

tobramycin 28 mg powder for inhalation, 224 capsules
10066T
Body System:
Manner of administration:Inhalation By Mouth
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17397)

Indication: Proven Pseudomonas aeruginosa infection
Treatment phase: Initial treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 224 # of repeats: 0 DPMQ: $2,418.71 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
TOBI podhaler

TOBRAMYCIN (10074F)

tobramycin 28 mg powder for inhalation, 224 capsules
10074F
Body System:
Manner of administration:Inhalation By Mouth
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17405)

Indication: Proven Pseudomonas aeruginosa infection
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 224 # of repeats: 2 DPMQ: $2,418.71 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
TOBI podhaler

TOBRAMYCIN (13965B)

tobramycin 28 mg powder for inhalation, 224 capsules
13965B
Body System:
Manner of administration:Inhalation By Mouth
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17328)

Indication: Proven Pseudomonas aeruginosa infection
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 448 # of repeats: 2 DPMQ: $4,728.64 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
TOBI podhaler