Interchangeable Grouping
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12:00 AUTONOMIC AGENTS
12:12:00 SYMPATHOMIMETIC (ADRENERGIC) AGENTS
LU Criteria Text
SALMETEROL XINAFOATE & FLUTICASONE PROPIONATE
50/500mcg Inh-60 Dose Pk
Interchangeables found: 3
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DIN/ PIN/ NPN
Brand Name
Drug Benefit Price or Unit Price
Amount MOH Pays:
02240837
Advair Diskus
173.6300
72.0600
02494523
PMS-FluticasonePropionateSalmeterol DPI
72.0600
72.0600
02495619
Wixela Inhub
72.0600
72.0600
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