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Sodium Citrate and Citric Acid 500 mg/5mL; 334 mg/5mL Solution — NDC 00121-0595-00 package photo
Label image from the product's FDA listing (DailyMed) — may show a different pack size or an older label revision.

Sodium Citrate and Citric Acid 500 mg/5mL; 334 mg/5mL Solution — NDC 0121-0595-00 (Billing 00121-0595-00)

by Pharmaceutical Associates, Inc. · 10 TRAY in 1 CASE / 10 CUP, UNIT-DOSE in 1 TRAY / 15 mL in 1 CUP, UNIT-DOSE

This is a package of Sodium Citrate and Citric Acid 500 mg/5mL; 334 mg/5mL Solution from Pharmaceutical Associates, Inc., marketed since Jan 1969 and currently FDA-listed.

NDC 00121-0595-00
🏷️ FDA NDC (as labeled) 0121-0595-00 billing pads the labeler segment with a zero
This package
Contains15 mL in 1 cup, unit-dose Medicaid pays$6.57 / unit · 12 mo Per package$9,848.10 / 1500 ml · Medicaid Pack sizes3 compare ↓
Product page 00121-0595-16 Also comes in: 10 cups 0121-0595-30 473 ml 0121-0595-16
Rx only On market Non-controlled ⇄ Compare with another NDC
🗂️ FDA directory synced Oct 1, 2026 · this listing last changed Oct 1, 2026 · sources: openFDA · FDA label (DailyMed) · FDA Orange & Purple Book · First Databank · CMS NADAC, ASP, Medicare & Medicaid · RxNorm
📋 All sources & update times →

This page is curated, coded, and maintained by

Compiled from public FDA, CMS, DailyMed, NADAC, and related drug data sources. Editorial policy

NDC database record

One package, one record: these facts belong to NDC 0121-0595-00 alone.

Record
FDA NDC Directory package listing · Human prescription drug
Code segments
0121 labeler · 0595 product · 00 package
Package marketed since
Jan 1, 1969
Sample package
No — commercial package
Listing certified through
Dec 31, 2026
Barcode (UPC-A, from the NDC)
3 0121059500 4
Medicaid fills, this package
190 prescriptions in the last four reported quarters
FDA record last changed
Oct 1, 2026

Identity & classification

Regulatory identifiers FDA, NLM and CMS codes for this package

FDA NDC (as labeled) 0121-0595-00
Product NDC 0121-0595
11-digit billing NDC 00121059500
NCPDP billing unit ML — per mL (volume)
RxCUI 543014
UNII 1Q73Q2JULR, XF417D3PSL
SPL Set ID 63201a61-6ac5-41ae-8b2d-ff0d3a8ddfd5
Established class (EPC) Calculi Dissolution Agent; Anti-coagulant
Mechanism of action Acidifying Activity; Calcium Chelating Activity
Physiologic effect Decreased Coagulation Factor Activity
DEA schedule Non-controlled
Marketing category UNAPPROVED DRUG OTHER
Marketing status On market
FDA listing status Listed (active directory)
Marketing start 1969-01-01
Route ORAL
Dosage form SOLUTION
Substance SODIUM CITRATE; ANHYDROUS CITRIC ACID

Drug-database identifiers Medi-Span GPI and First Databank GCN / HICL / AHFS classification

GPI-14 56202020002010
GPI class Sod Citrate-Citric Acid
GCN Seq No 043912
GCN 51957
HICL code 003682
Ingredient (HICL) Citric Acid/Sodium Citrate
HIC1 code R
Therapeutic class — broad (HIC1) Kidney/Urinary Tract
HIC2 code R1
Therapeutic class — intermediate (HIC2) Affect Primarily Kidneys/Urinary Tract
HIC3 code R1S
Therapeutic class — specific (HIC3) Urinary Ph Modifiers
AHFS code 40:08.00.00
AHFS class Alkalinizing Agents
FDB label name SOD CITRATE-CITRIC ACID CUP
FDB brand name Sodium Citrate-Citric Acid
Legend status Q — Non-drug — dietary supplement, vitamin, medical food, or herbal preparation
Quick answers
  • GSN (GCN sequence number): 043912
  • GCN: 51957
  • GPI-14 (Medi-Span): 56202020002010
  • HICL (First Databank): 003682
  • AHFS class code: 40:08.00.00
  • RxCUI (RxNorm): 543014
Why two NDCs? The FDA registers this code as 0121-0595-00 — a 4-4-2 layout, and that's what's printed on the package and shown on DailyMed. For insurance claims, every NDC is standardized to a uniform 11-digit 5-4-2 format by adding a zero to the labeler segment → 00121-0595-00. Same drug, same package — only the format differs.
Where does this data come from?
Identifiers from the FDA openFDA NDC Directory and Structured Product Labeling; RxCUI from RxNorm (NLM); GPI from Medi-Span; GCN / HIC / AHFS / legend from First Databank.

RxNorm drug class

This medicine belongs to the Calculi Dissolution Agent class.

Pharmacologic class Calculi Dissolution Agent, Anti-coagulant
Drug family (ATC) Acid preparations
How it works Calcium Chelating Activity, Acidifying Activity
Where does this data come from?
Therapeutic classes from RxNorm RxClass (U.S. National Library of Medicine) — Established Pharmacologic Class (FDA), ATC drug family (WHO) and mechanism of action, matched by this product’s RxCUI.

Clinical

Label name SOD CITRATE-CITRIC ACID CUP Ingredient Citric Acid/Sodium Citrate
🧪 What is this product?

This is an oral solution containing sodium citrate and citric acid, marketed without an approved FDA application. Sodium citrate and citric acid are salts and acids that are typically used to make urine less acidic and to help dissolve certain types of kidney stones. These ingredients also function in some contexts as anticoagulants or agents that bind calcium in blood. This product is dispensed by prescription and should be used only under a doctor's supervision.

Supplement & herbal interactions

🌿 Drug–supplement interaction checker →
Where does this data come from?
Plain-language summary from MedlinePlus (U.S. National Library of Medicine); supplement & herbal interactions and nutrient depletion data from the Natural Medicines database; our full guide is HelloPharmacist editorial content.

Pricing

A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.

Price systemPer mLPer package
Retail pharmacies payNADAC · weekly Not in the retail survey — common for institutional, discontinued, or low-volume packs.
Medicaid paysCMS SDUD · 12 mo $6.57 $9,848.10 / 1500 ml
Medicare drug plans payPart D · quarterly No Part D plan price is available for this NDC in our data.
Where does this data come from?
NADAC (National Average Drug Acquisition Cost) is the CMS weekly pharmacy-acquisition-cost survey — what pharmacies pay. ASP (Average Sales Price) is the CMS Medicare Part B drug-payment file, published quarterly. Medicaid pays is computed by us from CMS State Drug Utilization Data (total reimbursed ÷ units, trailing 12 months) — gross of rebates and inclusive of dispensing fees, so it reflects what Medicaid paid, not an acquisition cost. Medicare drug plans pay is the median negotiated point-of-sale unit cost across plans listing this NDC in the CMS quarterly Prescription Drug Plan pricing files, before rebates. The VA pays is the federal contract price (FSS, and the statutory Big 4 ceiling where listed) from the VA National Acquisition Center pharmaceutical price file. All are free public government data; each measures a different payer, so the figures are not directly comparable.

Packaging — all sizes for this product

Package NDCDescription Per unit Per pack Marketing startMarketing endStatus
00121-0595-00 You're viewing this 10 TRAY in 1 CASE / 10 CUP, UNIT-DOSE in 1 TRAY / 15 mL in 1 CUP, UNIT-DOSE — — 1969-01-01 — Active
00121-0595-16 0121-0595-16 Main listing 473 mL in 1 BOTTLE $0.0229 / mL $10.83 1969-01-01 — Active
00121-0595-30 0121-0595-30 10 TRAY in 1 CASE / 10 CUP, UNIT-DOSE in 1 TRAY / 30 mL in 1 CUP, UNIT-DOSE — — 1969-01-01 — Active

This pack accounts for about 1.1% of this product's recent Medicaid fills; most go to the 473 ml pack. See all packs ↓

Pack size FAQ

What quantity is in this package?
This package is listed by the FDA — 10 tray in 1 case / 10 cup, unit-dose in 1 tray / 15 ml in 1 cup, unit-dose.
What NDC number is used to bill for this package of Sodium Citrate and Citric Acid 500 mg/5mL; 334 mg/5mL Solution?
Use the 11-digit billing form listed in the identifiers section of this page. Pharmacy and medical claims use the 11-digit form; the FDA label may print a shorter form of the same code.

Prices are the latest CMS NADAC pharmacy acquisition cost per NDC; per-pack figures are per-unit × pack quantity, shown only when the pack is denominated in the same measure NADAC prices.

Therapeutic equivalents

ProductLabelerPackNADAC/unitTEStatusPrice vs. this
Sodium Citrate and Citric Acid 500 mg/5mL; 334 mg/5mL 62135-0434-47 Chartwell 473 ml $0.023 — Availability likely —
Sodium Citrate and Citric Acid 500 mg/5mL; 334 mg/5mLthis 00121-0595-00 Pharmaceutical 10 cups — — FDA listed —
Sodium Citrate and Citric Acid 500 mg/5mL; 334 mg/5mL 00121-1190-00 Pharmaceutical 10 cups — — FDA listed —
Sodium Citrate and Citric Acid 500 mg/5mL; 334 mg/5mL 17856-0595-04 Atlantic 1 cup — — FDA listed —
Sodium Citrate and Citric Acid 500 mg/5mL; 334 mg/5mL 50268-0182-15 AvPAK 40 cups — — FDA listed —
Sodium Citrate and Citric Acid 500 mg/5mL; 334 mg/5mL 50268-0183-30 AvPAK 40 cups — — FDA listed —
Sodium Citrate and Citric Acid 500 mg/5mL; 334 mg/5mL 55154-5777-05 Cardinal 5 cups — — FDA listed —
Sodium Citrate and Citric Acid 1500 mg/15mL; 1002 mg/15mL 60687-0832-16 American 10 cups — — FDA listed —
Sodium Citrate and Citric Acid 3000 mg/30mL; 2004 mg/30mL 60687-0834-76 American 10 cups — — FDA listed —
Sodium Citrate and Citric Acid 1500 mg/15mL; 1002 mg/15mL 62135-0868-24 Chartwell 10 cups — — FDA listed —
Sodium Citrate and Citric Acid 3000 mg/30mL; 2004 mg/30mL 62135-0869-24 Chartwell 10 cups — — FDA listed —
Sodium Citrate and Citric Acid 1500 mg/15mL; 1002 mg/15mL 68999-0868-24 Chartwell 10 cups — — FDA listed —
Sodium Citrate and Citric Acid 3000 mg/30mL; 2004 mg/30mL 68999-0869-24 Chartwell 10 cups — — FDA listed —
Sodium Citrate and Citric Acid 334 mg/5mL; 500 mg/5mL 81033-0017-50 Kesin 100 cups — — FDA listed —
Sodium Citrate and Citric Acid 500 mg/5mL; 334 mg/5mL 84447-0017-01 Belleview 200000 ml — — FDA listed —
About this product: other versions of the same ingredient, strength and form are listed above, least expensive first, with FDA equivalence ratings where available.
Where does this data come from?
Equivalents are other NDCs of the same ingredient, form and route from the openFDA NDC Directory, ranked least-expensive-first by NADAC. Therapeutic-equivalence (AB) ratings come from the FDA Orange Book; biologics use the FDA Purple Book for biosimilar & interchangeable status.

Availability & generic status

🏛️
1969
On the market since
Jan 1969
📍
2026
Currently FDA-listed
57 years listed
🔒
·
No generic listed yet
brand only
ℹ️No FDA-approved generic found

We did not find an FDA-approved generic match for this exact strength, form and route.

Where does this data come from?
Patents and exclusivity from the FDA Orange Book (small-molecule drugs), refreshed from public FDA data. Generic launch timing is an estimate, not a guarantee.

What it looks like

FlavorGrape
One label can cover several strengths, so colors may be combined — always confirm a loose pill against the dispensed prescription label or a pharmacist.
Where does this data come from?
Physical description (imprint, shape, color, scoring, coating) from this product’s FDA Structured Product Labeling (SPL), mirrored from DailyMed / openFDA.

Inactive Ingredients / Excipients

Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.

💡 Tap an ingredient (hover on desktop) to see what it is and why it’s used.

  • UNII 3WJQ0SDW1A
    Polyethylene glycol is a synthetic liquid or solid polymer used in medicines as a solvent, lubricant, and humectant. It helps dissolve active ingredients, reduces friction during manufacturing, and retains moisture in the final product.
  • UNII 6DC9Q167V3
    Propylene glycol is a clear liquid derived from petroleum or vegetable sources. It acts as a solvent, humectant, and preservative in medicines, helping dissolve active ingredients and maintain product stability.
  • UNII OJ245FE5EU
    Sodium benzoate is a salt derived from benzoic acid, a preservative. It's added to medicines to prevent growth of bacteria, fungi, and other microorganisms that could spoil the product.
  • UNII 506T60A25R
    Sorbitol is a natural sugar alcohol derived from glucose. It serves as a sweetener, humectant, and bulking agent in medications to improve taste and help maintain moisture in the product.
  • UNII 059QF0KO0R
    Water is a liquid solvent that dissolves and mixes ingredients together in liquid medicines, syrups, and injections. It helps distribute the active drug evenly throughout the product.

5 inactive ingredients listed in the exact product block matched to this NDC.

Where does this data come from?
Data sourced from official FDA Structured Product Labeling (SPL) via DailyMed — ingredient classCode="IACT" elements from the exact product block matched by this NDC. Label-section narrative from DailyMed / the openFDA label index is shown separately when available.

Inactive ingredient FAQ

Are inactive ingredients the same for every manufacturer?
No. Inactive ingredients can differ by manufacturer, dosage form, strength, and package / product version.
Why might an inactive ingredient be missing?
Some SPLs do not provide a complete structured inactive-ingredient list, and older or unusual labels may only include the information in narrative text.
Can inactive ingredients matter?
Yes. They can matter for allergies, intolerances, dyes, gluten / lactose concerns, preservatives, and formulation differences — but confirm with a pharmacist or the manufacturer when it’s clinically important.

Manufacturer & labeler

LabelerPharmaceutical Associates, Inc.
Labeler code00121
First marketedJan 1969
Product typeHuman Prescription Drug
Portfolio12 products on file

More NDCs from Pharmaceutical Associates, Inc. labeler code 00121

The labeler markets the product; the application holder owns the FDA approval. They’re often the same company but can differ (e.g. a repackager or an authorized generic). A mailing address / phone appears here when the manufacturer includes it in the product’s FDA label (not all do).
Where does this data come from?
Labeler, application holder and registered establishment from the FDA openFDA NDC Directory and Drugs@FDA; address/contact from the product’s FDA label.

Full prescribing information FDA SPL

The complete FDA label for this product — the official prescribing information, verbatim, section by section. Jump with a chip, search within the label, or expand everything.
🎯 Indications and Usage ⏱️ Dosage and Administration ⛔ Contraindications 🤒 Adverse Reactions 🆘 Overdosage 🧬 Clinical Pharmacology 📦 How Supplied / Storage and Handling 📦 Storage and Handling 📋 Description ⚠️ Precautions 📄 Package Label / Principal Display Panel
🎯 Indications and Usage 149 words ▾

INDICATIONS AND USAGE Sodium Citrate and Citric Acid Oral Solution USP is an effective alkalinizing agent. It is useful in those conditions where long-term maintenance of an alkaline urine is desirable, and is of value in the alleviation of chronic metabolic acidosis, such as results from chronic renal insufficiency or the syndrome of renal tubular acidosis, especially when the administration of potassium salts is undesirable or contraindicated. This product is also useful for buffering and neutralizing gastric hydrochloric acid quickly and effectively.

Sodium Citrate and Citric Acid Oral Solution USP is concentrated, and when administered after meals and before bedtime, allows one to maintain an alkaline urinary pH around the clock, usually without the necessity of a 2 A.M. dose. This product alkalinizes the urine without producing a systemic alkalosis in the recommended dosage. This product is highly palatable, pleasant tasting, and tolerable, even when administered for long periods.

⏱️ Dosage and Administration 27 words ▾

DOSAGE AND ADMINISTRATION Sodium Citrate and Citric Acid Oral Solution USP should be taken diluted in water, followed by additional water, if desired. SHAKE WELL BEFORE USING.

⛔ Contraindications 10 words ▾

CONTRAINDICATIONS Patients on sodium-restricted diets or with severe renal impairment.

🤒 Adverse Reactions 78 words ▾

ADVERSE REACTIONS Sodium Citrate and Citric Acid Oral Solution USP is generally well tolerated, without any unpleasant side effects, when given in recommended doses to patients with normal renal function and urinary output. However, as with any alkalinizing agent, caution must be used in certain patients with abnormal renal mechanisms to avoid development of alkalosis, especially in the presence of hypocalcemia. To report SUSPECTED ADVERSE REACTIONS, contact Pharmaceutical Associates, Inc. at 1-800-845-8210 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch..

🆘 Overdosage 14 words ▾

OVERDOSAGE Overdosage with sodium salts may cause diarrhea, nausea and vomiting, hypernoia, and convulsions.

🧬 Clinical Pharmacology 49 words ▾

CLINICAL PHARMACOLOGY Sodium citrate is absorbed and metabolized to sodium bicarbonate, thus acting as a systemic alkalizer. The effects are essentially those of chlorides before absorption and those of bicarbonates subsequently. Oxidation is virtually complete so that less than 5% of sodium citrate is excreted in the urine unchanged.

📦 How Supplied / Storage and Handling 82 words ▾

HOW SUPPLIED Sodium Citrate and Citric Acid Oral Solution USP (colorless, grape flavor) is supplied in the following oral dosage forms: NDC 0121-0595-16: 16 fl oz (473 mL) bottle NDC 0121-0595-15: 15 mL unit dose cup. Case contains 100 unit-dose cups of 15 mL (NDC 0121-0595-00), packaged in 10 trays of 10 unit-dose cups each. NDC 0121-1190-30: 30 mL unit dose cup.

Case contains 100 unit-dose cups of 30 mL (NDC 0121-1190-00) packaged in 10 trays of 10 unit-dose cups each. .

📦 Storage and Handling 14 words ▾

STORAGE: Keep tightly closed. Store at controlled room temperature, 20°-25°C (68°-77°F). Protect from freezing.

📋 Description 94 words ▾

DESCRIPTION Sodium Citrate and Citric Acid Oral Solution USP is a stable and pleasant-tasting systemic alkalizer containing sodium citrate and citric acid in a sugar-free base. It is a nonparticulate neutralizing buffer. Sodium Citrate and Citric Acid Oral Solution USP contains in each teaspoonful (5 mL): SODIUM CITRATE Dihydrate 500 mg (0.34 Molar) CITRIC ACID Monohydrate 334 mg (0.32 Molar) Each mL contains 1 mEq sodium ion and is equivalent to 1 mEq bicarbonate (HCO3).

Sodium citrate contains the following inactive ingredients: flavoring, polyethylene glycol, propylene glycol, purified water, sodium benzoate, and sorbitol solution.

⚠️ Precautions 109 words ▾

PRECAUTIONS Sodium Citrate and Citric Acid Oral Solution USP should be used with caution by patients with low urinary output unless under the supervision of a physician. This product should not be administered concurrently with aluminum-based antacids. Patients should be directed to dilute adequately with water and preferably, to take each dose after meals to avoid saline laxative effect.

Sodium salts should be used cautiously in patients with cardiac failure, hypertension, impaired renal function, peripheral and pulmonary edema, and toxemia of pregnancy. Periodic examinations and determinations of serum electrolytes, particularly serum bicarbonate level, should be carried out in those patients with renal disease in order to avoid these complications.

📄 Package Label / Principal Display Panel 197 words ▾

PRINCIPAL DISPLAY PANEL - 473 mL Bottle Label NDC 0121-0595-16 NSN 6505-01-097-4766 Sodium Citrate and Citric Acid Oral Solution USP 500 mg/334 mg per 5 mL A SUGAR-FREE SYSTEMIC ALKALIZER Each teaspoonful (5 mL) contains: Sodium Citrate Dihydrate..........500 mg Citric Acid Monohydrate............334 mg Each mL provides 1 mEq Sodium Ion and is equivalent to 1 mEq Bicarbonate (HCO3). Rx ONLY 16 fl oz (473 mL) Pharmaceutical Associates, Inc. Greenville, SC 29605 473 mL Bottle Label

PRINCIPAL DISPLAY PANEL - 15 mL Unit Dose Cup Label Delivers 15 mL NDC 0121-0595-15 S ODIUM C ITRATE and C ITRIC A CID O RAL S OLUTION USP (Sugar Free) 1.5 g/ 1 g per 15 mL SHAKE WELL-DILUTE AS DIRECTED Package Not Child-Resistant Rx ONLY PHARMACEUTICAL ASSOCIATES, INC. GREENVILLE, SC 29605 SEE INSERT 30 mL Unit Dose Cup Label

PRINCIPAL DISPLAY PANEL - 30 mL Unit Dose Cup Label Delivers 30 mL NDC 0121-1190-30 S ODIUM C ITRATE and C ITRIC A CID O RAL S OLUTION USP (Sugar Free) 3 g/ 2 g per 30 mL SHAKE WELL-DILUTE AS DIRECTED Package Not Child-Resistant Rx ONLY PHARMACEUTICAL ASSOCIATES, INC. GREENVILLE, SC 29605 SEE INSERT 30 mL Unit Dose Cup Label

Source: FDA Structured Product Labeling, mirrored from DailyMed / openFDA. Prefer the government’s original formatting? View this label on DailyMed ↗

Medicaid utilization & spend

📍 This exact package only: Medicaid data is reported per full 11-digit NDC — labeler, product and pack size — so every number here is for this package alone, not the drug overall. Other pack sizes report separately.
💊 Pharmacy benefit only: These are Medicaid outpatient pharmacy claims, billed by NDC. They exclude the medical benefit — clinic- or hospital-administered drugs billed under HCPCS J-codes — so drugs used mostly that way (e.g. Avastin, Lucentis, Keytruda) can look low or missing here. That’s expected, not an error.
📅 Q1 2025 – Q4 2025 · 4 quarters of data
ⓘ The newest quarter is usually incomplete when first published; states restate recent quarters in later CMS releases, so the latest figures typically revise upward. State coverage-policy changes can also shift quarter-to-quarter totals.
Prescriptions last 4 qtrs
190
Units reimbursed last 4 qtrs
132
Gross reimbursed last 4 qtrs
$866.63
Avg / prescription
$4.56
Avg / unit
$6.5654
Latest quarter Q4 2025
0Rx
Fee-for-service vs managed care ⓘ
100% MCO
Fee-for-service · 0 Rx Managed care · 190 Rx
State Medicaid map
Alaska: no data reported AK Maine: no data reported ME Washington: no data reported WA Idaho: no data reported ID Montana: no data reported MT North Dakota: no data reported ND Minnesota: no data reported MN Wisconsin: no data reported WI Michigan: no data reported MI New York: no data reported NY Vermont: no data reported VT New Hampshire: no data reported NH Oregon: no data reported OR Nevada: no data reported NV Wyoming: no data reported WY South Dakota: no data reported SD Iowa: no data reported IA Illinois: no data reported IL Indiana: no data reported IN Ohio: no data reported OH Pennsylvania: no data reported PA New Jersey: no data reported NJ Massachusetts: no data reported MA California: no data reported CA Utah: no data reported UT Colorado: no data reported CO Nebraska: no data reported NE Missouri: no data reported MO Kentucky: 132 units · 2.9 per 100k residents KY West Virginia: no data reported WV Virginia: no data reported VA Maryland: no data reported MD Connecticut: no data reported CT Rhode Island: no data reported RI Arizona: no data reported AZ New Mexico: no data reported NM Kansas: no data reported KS Arkansas: no data reported AR Tennessee: no data reported TN North Carolina: no data reported NC South Carolina: no data reported SC Delaware: no data reported DE Oklahoma: no data reported OK Louisiana: no data reported LA Mississippi: no data reported MS Alabama: no data reported AL Georgia: no data reported GA D.C.: no data reported DC Hawaii: no data reported HI Texas: no data reported TX Florida: no data reported FL
Units reimbursed · per 100k residents
2.92.9
gray = no data reported ⓘ
Colors are per 100,000 residents, so big states don’t automatically dominate. Tap or hover a state for its actual totals.
Tap or hover a state
…for its Medicaid breakdown
🏆 Top states by units · per 100k residents
1 Kentucky 2.9 /100k
National units — by quarter
💵 About the dollar figures: “reimbursed” is what Medicaid paid pharmacies before confidential manufacturer rebates, so the program’s real net cost is lower than these numbers. Fee-for-service and managed-care claims are combined unless split above. Source: CMS State Drug Utilization Data; per-100k rates use 2023 Census population estimates.

Medicaid utilization by pack size

Medicaid (SDUD) totals over the four most recent reported quarters for every package size of this drug — handy when a specific package (e.g. a starter/titration pack) carries little or no Medicaid volume on its own.
473 ml00121-0595-16 16,867 Rx · $480,997
10 cups this page00121-0595-00 190 Rx · $867
10 cups00121-0595-30 No Medicaid data
Drug total (last 4 qtrs): 17,057 Rx · 16,298,764 units · $481,864 gross reimbursed
Tap a pack size to open its page. Source: CMS State Drug Utilization Data, last 4 quarters.

About this NDC listing & data coverage

Finished prescription product Marketed without an FDA application

Listed without an FDA application

This product's marketing category indicates it is marketed without an approved FDA application (no NDA, ANDA, or BLA on file). Having an NDC does not by itself establish FDA approval — the NDC Directory is a listing system, not an approval decision. Approval-linked data such as Orange Book therapeutic-equivalence ratings therefore does not apply.

What data is (and isn’t) available for this NDC — tap to expand
NDC identity (package / product / labeler codes) ✓ Available
Labeler ✓ Available
Product & package description ✓ Available
Marketing category & status ✓ Available
Active ingredient / dosage form / route ✓ Available
FDA label (SPL via DailyMed) ✓ Available
Package photos ✓ Available
Inactive ingredients (structured) ✓ Available
NADAC pharmacy acquisition price (CMS) — Not published for this NDC CMS publishes NADAC only for NDCs reported in its retail-pharmacy survey.
Orange Book / therapeutic-equivalence data — Not published for this NDC Applies only to products approved under an NDA/ANDA; many listings are out of scope.
HCPCS J-code billing crosswalk — Not published for this NDC Most self-administered / retail products have no J-code — that is normal.
Medicaid utilization (CMS SDUD) ✓ Available
“Not published” reflects what the public FDA / CMS / NLM sources provide for this exact package code — it is a property of the data feeds, not a judgment about the product.

Questions about this listing

Is this NDC FDA-approved?
An NDC listing does not by itself establish FDA approval — the NDC Directory records that a product is listed with FDA, not that it was reviewed and approved. This listing's marketing category is "Unapproved Drug Other". Products approved under an application carry an NDA, ANDA, or BLA number.
Why is there no price listed?
The pricing shown on our NDC pages comes from CMS NADAC, a voluntary survey of retail community pharmacy invoices. CMS does not publish a NADAC for every NDC — packages outside the retail survey (institutional and hospital products, bulk packages, discontinued items, and many OTC items) may never receive one. A missing price reflects the survey's scope, not this product's actual cost, and does not mean the product is free or unavailable.
Is the NDC printed on the package the same as the 11-digit billing NDC?
Yes, they identify this exact package in different formats. The form printed on the packaging and shown on DailyMed is the one the FDA registered. Insurance claims use a fixed 11-digit 5-4-2 format, so the short segment is padded with a leading zero and the dashes are dropped. The Identity section at the top of this page lists each form of this code.
Is this package still being marketed?
Yes, per the latest FDA NDC Directory data on this page: this package is listed as actively marketed, with no marketing end date reported by Pharmaceutical Associates, Inc.. Listing status can change — the directory data on this page refreshes weekly.
Does this product come in other package sizes?
Yes — the FDA directory lists 2 other package presentations of this same product, including 10 cups (00121-0595-30), 473 ml (00121-0595-16). Each has its own NDC and its own page — see the package list near the top of this page.
Who lists this product with the FDA?
Pharmaceutical Associates, Inc. is the labeler of record for this NDC — the company under whose FDA-assigned code the package is listed. The labeler may be the manufacturer itself or a distributor marketing the product under its own code.
Do I need a prescription for this product?
This NDC is listed with FDA as a prescription product, so it is dispensed under a prescriber's order. Your pharmacist can tell you whether any over-the-counter forms of the same medication exist.
This page identifies an FDA-listed package (the NDC) and reports public regulatory and pricing data about the listing. It is reference information, not a medical recommendation — talk to your pharmacist or prescriber about your own medication.
Where does this data come from?
Listing facts (marketing category, packager status, marketing dates) from the FDA openFDA NDC Directory; label availability from DailyMed; pricing coverage from CMS NADAC; equivalence scope from the FDA Orange Book.
← 00121-0581-04 · PAI 00121-0638-00 · PAI →
For educational and professional reference only — not medical advice. Pricing reflects published NADAC and CMS ASP (free public data) and may differ from your acquisition cost; always verify before billing or dispensing.