REMODULIN 2.5 MG/ML VIAL

Drug Details

General

Brand Name: REMODULIN 2.5 MG/ML VIAL
Generic Name: treprostinil sodium
Manufacturer: UNITED THERAP
NDC: 66302010201
Package size: 20ML
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: 155.9817
Retail Pharmacy Eff Date: 04/10/2018
Specialty Pharmacy Cost: 146.4318
Specialty Pharmacy Eff Date: 04/10/2018
Long-term Care Pharmacy Cost: 153.75339
Long-term Care Pharmacy Eff Date: 04/10/2018
340B Cost: 68.44095
Premium Preferred Generic Incentive†: Yes

Program Coverage

Medicaid

Effective date: 11/27/2002
Compound-only use: No

CHIP

Effective date: 11/27/2002
Compound-only use: No

CSHCN

Effective date: 11/27/2002
Compound-only use: No
Comments: Refer to program requirements