Product Details
PMS-Fluticasone HFA
Fluticasone Propionate
50 mcg/Metered-Dose
Inhalation Aerosol
120-Dose Pack
DIN/PIN/NPN
02503115
Manufacturer
Pharmascience Inc.
Formulary Listing Date
2023-03-31
Unit Price
21.3150
Amount MOH Pays
21.3150
Coverage Status
General Benefit
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
R03BA05
Interchangeable Products
| DIN/ PIN/ NPN |
Brand name |
Unit Price |
Amount MOH pays |
| 02244291 |
Flovent HFA |
31.9000 |
21.3150 |
| 02503115 |
PMS-Fluticasone HFA |
21.3150 |
21.3150 |
LU Clinical Criteria
NO
EAP Criteria
NO
Product Monograph
View Monograph