HYZAAR 50-12.5 TABLET

Drug Details

General

Brand Name: HYZAAR 50-12.5 TABLET
Generic Name: losartan/hydrochlorothiazide
Manufacturer: ORGANON LLC
NDC: 78206013902
Package size: 90EA

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: 4.53201
Retail Pharmacy Eff Date: 07/18/2023
Specialty Pharmacy Cost: 4.45269
Specialty Pharmacy Eff Date: 07/18/2023
Long-term Care Pharmacy Cost: 4.42324
Long-term Care Pharmacy Eff Date: 07/18/2023
340B Rate: 2.02696
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.