RALTITREXED

RALTITREXED (4610P)

raltitrexed 2 mg injection, 1 vial
4610P
Body System:
Manner of administration:Injection
Public
Chemotherapy Items for Public Hospital use
No restrictions
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 7 mg # of repeats: 8 DPMA: $1,134.07 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Tomudex
(raltitrexed 2 mg injection, 1 vial)

RALTITREXED (7256X)

raltitrexed 2 mg injection, 1 vial
7256X
Body System:
Manner of administration:Injection
Private
Chemotherapy Items for Private Hospital use
No restrictions
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 7 mg # of repeats: 8 DPMA: $1,194.34 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Tomudex
(raltitrexed 2 mg injection, 1 vial)