SELECT-OB + DHA PACK

Drug Details

Brand Name: SELECT-OB + DHA PACK

Generic Name: prenatal vit 33/iron/folic/dha

Manufacturer: EXELTIS USA, IN

NDC: 00642007530

Package size: 60EA

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: 2.08936

Retail Pharmacy Eff Date: 02/21/2023

Specialty Pharmacy Cost: 1.96144

Specialty Pharmacy Eff Date: 02/21/2023

Long-term Care Pharmacy Cost: 2.05951

Long-term Care Pharmacy Eff Date: 02/21/2023

340B Rate: .91676

Premium Preferred Generic Incentive‡: No

Effective date: 04/14/2010

Compound-only use: No

PDL PA Required: No

PDL Class: PRENATAL VITAMINS

FFS Clinical PA Required‡: No

Part B Cost-share Drug**: No

Part D Wrap-around Drug***: Yes

Effective date: 04/14/2010

Effective date: 04/14/2010

Compound-only use: No