DIN/PIN/NPN Detail |
|
| 12:00 AUTONOMIC AGENTS | Therapeutic Note(s) |
| 12:12:00 SYMPATHOMIMETIC (ADRENERGIC) AGENTS | LU Criteria Text |
Trelegy Ellipta (FLUTICASONE FUROATE & UMECLIDINIUM BROMIDE & VILANTEROL TRIFENATATE)100mcg & 62.5mcg & 25mcg Pd Inh-30 Dose Pk
DIN/PIN/NPN:02474522
| Interchangeables: | NO |
| Manufacturer: | GlaxoSmithKline Inc., GlaxoSmithKline Consumer Health Care |
| Formulary Listing Date: | 2019-09-30 |
| Drug Benefit Price or Unit Price: | 137.6700 |
| Amount MOH Pays: | 137.6700 |
| Coverage Status: |
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