General Information

Generic Name: 
benazepril HCl
NDC code: 
00185005301
Package Size: 
100
EA
Prescription/OTC: 
Prescription required
Family Planning drug: 
No
Diabetic Supply: 
No
HTW Drug: 
Yes
Refill-to-soon Utilization*: 
75%

Drug Pricing

Retail Pharmacy Cost: 
.04721
Retail Pharmacy Eff Date: 
03/26/2019
Specialty Pharmacy Cost: 
.04638
Specialty Pharmacy Eff Date: 
03/26/2019
Long-term Care Pharmacy Cost: 
.04607
Long-term Care Pharmacy Eff Date: 
03/26/2019
340B Cost: 
.06983
Premium Preferred Generic Incentive†: 
No

 

* Impacts only claims paid by the Vendor Drug Program: traditional Medicaid, CSHCN, HTW, and KHC Programs.

† To learn about traditional Medicaid claim pricing and PPG pricing incentives please refer to the Drug Pricing & Reimbursement (PDF) chapter of the VDP Pharmacy Provider Procedure Manual.

‡ Please review the lists of DUR board-approved clinical prior authorizations that apply to traditional Medicaid and those that health plans may use. The Pharmacy Clinical Prior Authorization Assistance Chart (PDF) shows the prior authorization each health plan uses and how those authorizations relate to the authorizations used for traditional Medicaid claim processing. Refer to the MCO Resources for links to each health plan's active clinical prior authorizations.

Program Coverage

Medicaid

Med Effective Date: 
04/30/2004
Med End Date: 
05/31/2019
FFS Clinical PA Required ‡: 
No

CHIP

CHIP Effective Date: 
04/30/2004
CHIP End Date: 
05/31/2019

CSHCN

CSHCN Effective date: 
04/30/2004
CSHCN End date: 
05/31/2019

KHC

KHC Effective date: 
04/30/2004
KHC End date: 
05/31/2019

HTW Program

HTW Effective Date: 
07/01/2016
HTW End Date: 
05/31/2019

Compound-only Use by Program

Medicaid: 
No
CHIP: 
No
CSHCN: 
No
KHC: 
No