PNV 11/IRON FUM/FOLIC ACID/OM3
† Impacts only claims paid by the Vendor Drug Program: traditional Medicaid, CSHCN, HTW, and KHC Programs.
Retail Pharmacy Cost:
Retail Pharmacy Eff Date:
Specialty Pharmacy Cost:
Specialty Pharmacy Eff Date:
Long-term Care Pharmacy Cost:
Long-term Care Pharmacy Eff Date:
Premium Preferred Generic Incentive:
To learn about VDP pricing and VDP PPG pricing incentives please refer to the Drug Pricing & Reimbursement (PDF) chapter of the Texas Medicaid Pharmacy Provider Procedure Manual.