DIN/PIN/NPN Detail
68:00 HORMONES AND SUBSTITUTES
68:04:00 CORTICOSTEROIDS
Alvesco
(CICLESONIDE)
200mcg/Actuation Inh-120 Dose Pk
DIN/PIN/NPN:
02285614
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Interchangeables:
NO
Manufacturer:
Covis Pharma B.V.
Formulary Listing Date:
2007-06-06
Drug Benefit Price or Unit Price:
91.4739
Amount MOH Pays:
91.4739
Coverage Status:
General Benefit
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