BUDESONIDE + GLYCOPYRRONIUM + FORMOTEROL
budesonide 160 microgram/actuation + glycopyrronium 7.2 microgram/actuation + formoterol
fumarate dihydrate 5 microgram/actuation inhalation, 120 actuations
Manner of administration:Inhalation By Mouth
Restriction (Streamlined authority code: 12349)
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: $79.30 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Breztri Aerosphere | |||||
budesonide 160 microgram/actuation + glycopyrronium 7.2 microgram/actuation + formoterol
fumarate dihydrate 5 microgram/actuation inhalation, 120 actuations
Manner of administration:Inhalation By Mouth
Restriction (Streamlined authority code: 15543)
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: $146.36 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Breztri Aerosphere | |||||