ETHAMBUTOL HCL 400 MG TABLET

Drug Details

General

Brand Name: ETHAMBUTOL HCL 400 MG TABLET
Generic Name: ethambutol HCl
Manufacturer: TEVA USA
NDC: 00555092302
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: .75703
Retail Pharmacy Eff Date: 03/23/2021
Specialty Pharmacy Cost: .74378
Specialty Pharmacy Eff Date: 03/23/2021
Long-term Care Pharmacy Cost: .73886
Long-term Care Pharmacy Eff Date: 03/23/2021
340B Cost: .54627
Premium Preferred Generic Incentive†: Yes

Program Coverage

Medicaid

Effective date: 03/01/2002
End date: 10/31/2021
End reason: No Longer Rebatable
Compound-only use: No

CHIP

Effective date: 03/01/2002
End date: 10/31/2021
End reason: No Longer Rebatable
Compound-only use: No

CSHCN

Effective date: 03/01/2002
End date: 10/31/2021
End reason: No Longer Rebatable
Compound-only use: No