ALPRAZOLAM ODT 0.25 MG TAB

Drug Details

General

Brand Name: ALPRAZOLAM ODT 0.25 MG TAB
Generic Name: alprazolam
Manufacturer: ACTAVIS/TEVA
NDC: 00228401911
Package size: 100EA

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*: 90%
Specialty Drug†: No

Drug Pricing

Retail Pharmacy Cost: 1.05742
Retail Pharmacy Eff Date: 09/26/2023
Specialty Pharmacy Cost: .99268
Specialty Pharmacy Eff Date: 09/26/2023
Long-term Care Pharmacy Cost: 1.04231
Long-term Care Pharmacy Eff Date: 09/26/2023
340B Rate: .46397
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.