ALBUTEROL SUL 2.5 MG/3 ML SOLN

Drug Details

Brand Name: ALBUTEROL SUL 2.5 MG/3 ML SOLN

Generic Name: albuterol sulfate

Manufacturer: RITEDOSE PHARMA

NDC: 76204020001

Package size: 3ML

Family Planning drug: No

Diabetic Supply Drug: No

HTW drug: No

HTWPlus drug: Yes

Long-acting reversible contraception product: No

Refill-to-soon Utilization*: 75%

Specialty Drug†: No

Retail Pharmacy Cost: .0663

Retail Pharmacy Eff Date: 02/27/2024

Specialty Pharmacy Cost: .06513

Specialty Pharmacy Eff Date: 02/27/2024

Long-term Care Pharmacy Cost: .0647

Long-term Care Pharmacy Eff Date: 02/27/2024

340B Rate: .05446

Premium Preferred Generic Incentive‡: No

Effective date: 08/09/2013

Compound-only use: No

PDL PA Required: No

PDL Class: BRONCHODILATORS: BETA AGONIST

FFS Clinical PA Required‡: Yes

Part B Cost-share Drug**: Yes

Part D Wrap-around Drug***: No

Effective date: 08/09/2013

Effective date: 08/09/2013

Compound-only use: No

Effective date: 09/01/2020