FLUTICASONE PROPIONATE + SALMETEROL

fluticasone propionate 50 microgram/actuation + salmeterol 25 microgram/actuation inhalation, 120 actuations

FLUTICASONE PROPIONATE + SALMETEROL (8517G)

fluticasone propionate 50 microgram/actuation + salmeterol 25 microgram/actuation inhalation, 120 actuations
8517G
Body System:
Manner of administration:Inhalation By Mouth
General Schedule
Authority Required (STREAMLINED)

Restriction  4930

Indication: Asthma
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 5 DPMQ: $44.26 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
PAVTIDE MDI 50/25
Seretide MDI 50/25
*Additional charge for this brand is $4.00
 DPMQ: $48.26 Max safety net: $25.00 General Patient Charge: $29.00