DIN/PIN/NPN Detail |
|
| 12:00 AUTONOMIC AGENTS | |
| 12:12:00 SYMPATHOMIMETIC (ADRENERGIC) AGENTS | LU Criteria Text |
Breztri Aerosphere (BUDESONIDE&GLYCOPYRRONIUM (GLYCOPYRRONIUM BROMIDE)&FORMOTEROL FUMARATE DIHYDRATE)160mcg & 7.2mcg & 5mcg/Act Metered Dose Inh-120 Dose Pk
DIN/PIN/NPN:02518058
| Interchangeables: | NO |
| Manufacturer: | AstraZeneca |
| Formulary Listing Date: | 2022-10-31 |
| Drug Benefit Price or Unit Price: | 127.0000 |
| Amount MOH Pays: | 127.0000 |
| Coverage Status: |
|