COMPLETE NATAL DHA

Drug Details

General

Brand Name: COMPLETE NATAL DHA
Generic Name: PNV cmb 52/iron/FA/omega-3/dha
Manufacturer: TRIGEN LABORATO
NDC: 13811001030
Package size: 60EA

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: .34185
Retail Pharmacy Eff Date: 04/26/2022
Specialty Pharmacy Cost: .32092
Specialty Pharmacy Eff Date: 04/26/2022
Long-term Care Pharmacy Cost: .33696
Long-term Care Pharmacy Eff Date: 04/26/2022
340B Rate: .14999
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.