SULFAMYLON 8.5% CREAM

Drug Details

General

Brand Name: SULFAMYLON 8.5% CREAM
Generic Name: mafenide acetate
Manufacturer: MYLAN/RISING PH
NDC: 51079062383
Package size: 453.6GM
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: .90094
Retail Pharmacy Eff Date: 06/01/2016
Specialty Pharmacy Cost: .84578
Specialty Pharmacy Eff Date: 06/01/2016
Long-term Care Pharmacy Cost: .88807
Long-term Care Pharmacy Eff Date: 06/01/2016
340B Cost: .39531
Premium Preferred Generic Incentive†: Yes

Program Coverage

Medicaid

Effective date: 02/14/2007
Compound-only use: No

CHIP

Effective date: 02/14/2007
Compound-only use: No

CSHCN

Effective date: 02/14/2007
Compound-only use: No