DEXTROAMPHETAMINE 5 MG TAB

Drug Details

General

Brand Name: DEXTROAMPHETAMINE 5 MG TAB
Generic Name: dextroamphetamine sulfate
Manufacturer: TEVA USA
NDC: 00555095202
Package size: 100EA
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%

Drug Pricing

Retail Pharmacy Cost: .10512
Retail Pharmacy Eff Date: 03/23/2021
Specialty Pharmacy Cost: .10328
Specialty Pharmacy Eff Date: 03/23/2021
Long-term Care Pharmacy Cost: .10259
Long-term Care Pharmacy Eff Date: 03/23/2021
340B Cost: .645
Premium Preferred Generic Incentive†: Yes

Program Coverage

Medicaid

Effective date: 03/01/2002
Compound-only use: No

CHIP

Effective date: 03/01/2002
Compound-only use: No

CSHCN

Effective date: 03/01/2002
Compound-only use: No