DIN/PIN/NPN Detail

68:00 HORMONES AND SUBSTITUTES

68:04:00 CORTICOSTEROIDS

LU Criteria Text

Pulmicort Nebuamp (BUDESONIDE)0.125mg/mL Inh Susp

DIN/PIN/NPN:02229099

Interchangeables:

Manufacturer:

Formulary Listing Date:

1998-12-31

Drug Benefit Price or Unit Price:

0.2538

Amount MOH Pays:

0.1143

Coverage Status:

Limited Use Product