ZITHROMAX 200 MG/5 ML SUSP

Drug Details

General

Brand Name: ZITHROMAX 200 MG/5 ML SUSP
Generic Name: azithromycin
Manufacturer: PFIZER US PHARM
NDC: 00069314019
Package size: 30ML

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: .8673
Retail Pharmacy Eff Date: 01/04/2022
Specialty Pharmacy Cost: .8142
Specialty Pharmacy Eff Date: 01/04/2022
Long-term Care Pharmacy Cost: .85491
Long-term Care Pharmacy Eff Date: 01/04/2022
340B Rate: .38055
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.