OLMSRTN-AMLDPN-HCTZ 40-10-25MG

Drug Details

General

Brand Name: OLMSRTN-AMLDPN-HCTZ 40-10-25MG
Generic Name: olmesartan/amlodipin/hcthiazid
Manufacturer: SUN PHARMACEUTI
NDC: 57664080083
Package size: 30EA
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%

Drug Pricing

Retail Pharmacy Cost: 2.17395
Retail Pharmacy Eff Date: 03/23/2021
Specialty Pharmacy Cost: 2.1359
Specialty Pharmacy Eff Date: 03/23/2021
Long-term Care Pharmacy Cost: 2.12177
Long-term Care Pharmacy Eff Date: 03/23/2021
340B Cost: 1.97155
Premium Preferred Generic Incentive†: Yes

Program Coverage

Medicaid

Effective date: 02/21/2017
Compound-only use: No

CHIP

Effective date: 02/21/2017
Compound-only use: No

CSHCN

Effective date: 02/21/2017
Compound-only use: No