SELECT-OB + DHA PACK

Drug Details

General

Brand Name: SELECT-OB + DHA PACK
Generic Name: prenatal vit 33/iron/folic/dha
Manufacturer: EXELTIS USA, IN
NDC: 00642007530
Package size: 60EA

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: 2.15208
Retail Pharmacy Eff Date: 01/16/2024
Specialty Pharmacy Cost: 2.02032
Specialty Pharmacy Eff Date: 01/16/2024
Long-term Care Pharmacy Cost: 2.12133
Long-term Care Pharmacy Eff Date: 01/16/2024
340B Rate: .94428
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.