ACUVAIL 0.45% OPHTH SOLUTION

Drug Details

General

Brand Name: ACUVAIL 0.45% OPHTH SOLUTION
Generic Name: ketorolac tromethamine/PF
Manufacturer: ALLERGAN INC.
NDC: 00023350731
Package size: 30EA

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: 10.91818
Retail Pharmacy Eff Date: 12/21/2021
Specialty Pharmacy Cost: 10.24972
Specialty Pharmacy Eff Date: 12/21/2021
Long-term Care Pharmacy Cost: 10.7622
Long-term Care Pharmacy Eff Date: 12/21/2021
340B Rate: 4.79063
Premium Preferred Generic Incentive‡: No

* 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.