Product Details

Flovent HFA

Fluticasone Propionate
125 mcg/Metered-Dose
Inhalation Aerosol
120-Dose Pack

DIN/PIN/NPN

02244292

Manufacturer

GlaxoSmithKline Inc., GlaxoSmithKline Consumer Health Care

Formulary Listing Date

2002-07-29  

Unit Price

55.0200

Amount MOH Pays

23.4100

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
02244292 Flovent HFA 55.0200 23.4100
02526557 Apo-Fluticasone HFA 23.4100 23.4100
02503123 PMS-Fluticasone HFA 23.4100 23.4100
 

LU Clinical Criteria

NO  

EAP Criteria

NO

Product Monograph

View Monograph