TIROFIBAN
Body System:
Manner of administration:Injection
Restriction (Streamlined authority code: 16123)
Indication: High risk of unstable angina
Restriction (Streamlined authority code: 16147)
Indication: High risk of unstable angina
Restriction (Streamlined authority code: 16063)
Indication: Non-Q-wave myocardial infarction
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 1 | # of repeats: 2 | DPMQ: $183.88 | Max safety net: $25.00 | General Patient Charge: $25.00 |
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