BUPRENORPHINE-NALOX 12-3MG FLM

Drug Details

Brand Name: BUPRENORPHINE-NALOX 12-3MG FLM

Generic Name: buprenorphine HCl/naloxone HCl

Manufacturer: SANDOZ

NDC: 00781724964

Package size: 30EA

Family Planning drug: No

Diabetic Supply Drug: No

HTW drug: No

HTWPlus drug: Yes

Long-acting reversible contraception product: No

Refill-to-soon Utilization*: 90%

Specialty Drug†: No

Retail Pharmacy Cost: 14.373

Retail Pharmacy Eff Date: 03/09/2021

Specialty Pharmacy Cost: 13.49302

Specialty Pharmacy Eff Date: 03/09/2021

Long-term Care Pharmacy Cost: 14.16767

Long-term Care Pharmacy Eff Date: 03/09/2021

340B Rate: 6.30652

Premium Preferred Generic Incentive‡: No

Effective date: 05/29/2019

Compound-only use: No

PDL PA Required: No

PDL Class: OPIATE DEPENDENCE TREATMENTS

FFS Clinical PA Required‡: Yes

Part B Cost-share Drug**: No

Part D Wrap-around Drug***: No

Effective date: 05/29/2019

Effective date: 05/29/2019

Compound-only use: No

Effective date: 09/01/2020