MOTION SICKNESS RLF 25 MG TAB

Drug Details

Brand Name: MOTION SICKNESS RLF 25 MG TAB

Generic Name: meclizine HCl

Manufacturer: LEADER

NDC: 70000009701

Package size: 32EA

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

Retail Pharmacy Cost: .14708

Retail Pharmacy Eff Date: 02/28/2023

Specialty Pharmacy Cost: .1445

Specialty Pharmacy Eff Date: 02/28/2023

Long-term Care Pharmacy Cost: .14355

Long-term Care Pharmacy Eff Date: 02/28/2023

Premium Preferred Generic Incentive‡: No

Effective date: 01/10/2022

Compound-only use: No

PDL PA Required: No

PDL Class: ANTIEMETIC/ANTIVERTIGO AGENTS

FFS Clinical PA Required‡: Yes

Part B Cost-share Drug**: No

Part D Wrap-around Drug***: Yes

Effective date: 01/10/2022

Compound-only use: No