MIRTAZAPINE 15 MG TABLET

Drug Details

General

Brand Name: MIRTAZAPINE 15 MG TABLET
Generic Name: mirtazapine
Manufacturer: AUROBINDO PHARM
NDC: 13107003134
Package size: 30EA

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: .06611
Specialty Pharmacy Cost: .06499
Long-term Care Pharmacy Cost: .06452
340B Rate: .12756
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.