HYDROCHLOROTHIAZIDE 12.5 MG CP

Drug Details

General

Brand Name: HYDROCHLOROTHIAZIDE 12.5 MG CP
Generic Name: hydrochlorothiazide
Manufacturer: SCIEGEN PHARMAC
NDC: 50228014601
Package size: 100EA
Family Planning drug: No
Diabetic Supply Drug: No
HTW drug: Yes
HTWPlus drug: No
Long-acting reversible contraception product: No
Refill-to-soon Utilization*: 75%

Drug Pricing

Retail Pharmacy Cost: .03783
Retail Pharmacy Eff Date: 03/23/2021
Specialty Pharmacy Cost: .03716
Specialty Pharmacy Eff Date: 03/23/2021
Long-term Care Pharmacy Cost: .03692
Long-term Care Pharmacy Eff Date: 03/23/2021
340B Cost: .03435
Premium Preferred Generic Incentive†: Yes

Program Coverage

Medicaid

Effective date: 09/20/2019
Compound-only use: No

CHIP

Effective date: 09/20/2019
Compound-only use: No

CSHCN

Effective date: 09/20/2019
Compound-only use: No

HTW

Effective date: 01/15/2020