BIVALIRUDIN

bivalirudin 250 mg injection, 1 vial
Manner of administration:Injection
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 4919)

Indication: Coronary artery disease
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: 0 DPMQ: $476.05 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
BIVALIRUDIN ARX
BIVALIRUDIN MEDSURGE