CALCIPOTRIENE-BETAMETH DP SUSP

Drug Details

General

Brand Name: CALCIPOTRIENE-BETAMETH DP SUSP
Generic Name: calcipotriene/betamethasone
Manufacturer: TOLMAR INC.
NDC: 63646004060
Package size: 60GM

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: 13.63768
Retail Pharmacy Eff Date: 01/23/2024
Specialty Pharmacy Cost: 12.80272
Specialty Pharmacy Eff Date: 01/23/2024
Long-term Care Pharmacy Cost: 13.44285
Long-term Care Pharmacy Eff Date: 01/23/2024
340B Rate: 5.98388
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.