FORMOTEROL

formoterol fumarate dihydrate 12 microgram powder for inhalation, 60 capsules

FORMOTEROL (14419X)

formoterol fumarate dihydrate 12 microgram powder for inhalation, 60 capsules
14419X
Manner of administration:Inhalation By Mouth
General Schedule
Restricted Benefit

Restriction

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: 120 # of repeats: 5 DPMQ: $47.78 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Foradile