FLUTICASONE FUROATE + VILANTEROL
fluticasone furoate 200 microgram/actuation + vilanterol 25 microgram/actuation powder
for inhalation, 30 actuations
Manner of administration:Inhalation By Mouth
Restriction (Streamlined authority code: 4731)
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: $71.30 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Breo Ellipta 200/25 | |||||
fluticasone furoate 200 microgram/actuation + vilanterol 25 microgram/actuation powder
for inhalation, 30 actuations
Manner of administration:Inhalation By Mouth
Restriction (Streamlined authority code: 15692)
Indication: Asthma
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: $129.56 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Breo Ellipta 200/25 | |||||