DIN/PIN/NPN Detail |
|
| 12:00 AUTONOMIC AGENTS | |
| 12:12:00 SYMPATHOMIMETIC (ADRENERGIC) AGENTS | LU Criteria Text |
PMS-FluticasonePropionateSalmeterol DPI (SALMETEROL XINAFOATE & FLUTICASONE PROPIONATE)50/500mcg Inh-60 Dose Pk
DIN/PIN/NPN:02494523
| Interchangeables: | YES |
| Manufacturer: | Pharmascience Inc. |
| Formulary Listing Date: | 2020-04-30 |
| Drug Benefit Price or Unit Price: | 72.0600 |
| Amount MOH Pays: | 72.0600 |
| Coverage Status: |
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