Pharmacy Rates are established on a unit measure price basis, and are standardized for NDCs within each generic sequence number (GSN). A GSN groups a set of NDCs with the same active ingredients, dosage form, and strength, regardless of vendor brand or generic description. Currently, rates are computed based on the median unit measure cost for all listed NDCs in each GSN group. The mediun unit measure price is applied to all the NDCs in each GSN group.
As of January 2010, unit measure prices reflect the median TRICARE allowable ingredient costs.
- For the most accurate information on whether a specific drug requires prior authorization, please use the Formulary Search Tool.
- Before submitting claims to other health insurance carriers, MTFs should review the insurance carrier's website for its current list of pharmaceuticals requiring prior authorization.