DIN/PIN/NPN Detail |
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12:00 AUTONOMIC AGENTS | |
12:12:00 SYMPATHOMIMETIC (ADRENERGIC) AGENTS | LU Criteria Text |
Breztri Aerosphere (BUDESONIDE & FORMOTEROL FUMARATE DIHYDRATE & GLYCOPYRRONIUM)182mcg & 5.8mcg & 8.2mcg/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: |
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