ACLIDINIUM + FORMOTEROL
aclidinium 340 microgram/actuation + formoterol fumarate dihydrate 12 microgram/actuation
powder for inhalation, 60 actuations
Manner of administration:Inhalation By Mouth
Restriction (Streamlined authority code: 7798)
Indication: Chronic obstructive pulmonary disease (COPD)
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: $80.00 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Brimica Genuair | |||||
aclidinium 340 microgram/actuation + formoterol fumarate dihydrate 12 microgram/actuation
powder for inhalation, 60 actuations
Manner of administration:Inhalation By Mouth
Restriction (Streamlined authority code: 15691)
Indication: Chronic obstructive pulmonary disease (COPD)
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 2 | # of repeats: 5 | DPMQ: $147.84 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Brimica Genuair | |||||