FLUTICASONE PROPIONATE

fluticasone propionate 100 microgram/actuation powder for inhalation, 60 actuations
Manner of administration:Inhalation By Mouth
General Schedule
Restricted Benefit

Restriction

Indication: The condition must be stable for the prescriber to consider the listed maximum quantity of this medicine suitable for this patient.
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: $25.52 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Axotide Junior Accuhaler
Flixotide Junior Accuhaler
*Additional charge for this brand is $8.00
DPMQ: $33.52 Max safety net: $25.00 General Patient Charge: $33.00
fluticasone propionate 100 microgram/actuation powder for inhalation, 60 actuations
Manner of administration:Inhalation By Mouth
General Schedule
No restrictions
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: $19.65 Max safety net: $21.13 General Patient Charge: $23.92
Available brands
Axotide Junior Accuhaler
Flixotide Junior Accuhaler
*Additional charge for this brand is $4.00
DPMQ: $23.65 Max safety net: $21.13 General Patient Charge: $27.92