ABILIFY MAINTENA ER 300 MG SYR

Drug Details

General

Brand Name: ABILIFY MAINTENA ER 300 MG SYR
Generic Name: aripiprazole
Manufacturer: OTSUKA AMERICA
NDC: 59148004580
Package size: 1EA

Drug Information

Family Planning drug: No
Diabetic Supply Drug: No
HTW drug: No
HTWPlus drug: No
Long-acting reversible contraception product: No
Refill-to-soon Utilization*: 75%
Specialty Drug†: No

Drug Pricing

Retail Pharmacy Cost: 2018.09309
Retail Pharmacy Eff Date: 01/30/2024
Specialty Pharmacy Cost: 1982.77646
Specialty Pharmacy Eff Date: 01/30/2024
Long-term Care Pharmacy Cost: 1969.65885
Long-term Care Pharmacy Eff Date: 01/30/2024
340B Rate: 909.3984
Premium Preferred Generic Incentive‡: No
Admin. fee: 11.23

* Impacts only claims paid by HHSC: traditional Medicaid, CSHCN, HTW, and KHC Programs.

† Refer to the Specialty Drug Handbook for more information..

‡ Refer to the Premium Preferred Generic Drugs section for information about traditional Medicaid claim pricing and PPG pricing incentives.