Additional information
Formulary Category | 3 |
---|---|
Restrictions | Step Therapy |
What we cover | Non-Formulary Brand |
Cost* | $68 |
Cost mail** | N/A |
Budesonide-Glycopyrrolate-Formoterol Fumarate Aero 160-9-4.8 Mcg/Act (Generic)
Formulary Category | 3 |
---|---|
Restrictions | Step Therapy |
What we cover | Non-Formulary Brand |
Cost* | $68 |
Cost mail** | N/A |