BELLADONNA-OPIUM 16.2-30 SUPP

Drug Details

General

Brand Name: BELLADONNA-OPIUM 16.2-30 SUPP
Generic Name: opium/belladonna alkaloids
Manufacturer: PERRIGO/PADAGIS
NDC: 00574704512
Package size: 12EA

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: 21.57387
Retail Pharmacy Eff Date: 07/28/2020
Specialty Pharmacy Cost: 20.25302
Specialty Pharmacy Eff Date: 07/28/2020
Long-term Care Pharmacy Cost: 21.26567
Long-term Care Pharmacy Eff Date: 07/28/2020
340B Rate: 9.46608
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.