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    NDC 00121-0942-16 Phenobarbital Oral Solution 20 mg/5mL Details

    Phenobarbital Oral Solution 20 mg/5mL

    Phenobarbital Oral Solution is a ORAL SOLUTION in the HUMAN PRESCRIPTION DRUG category. It is labeled and distributed by PAI Holdings, LLC. The primary component is PHENOBARBITAL.

    Product Information

    NDC 00121-0942
    Product ID 0121-0942_bcf8792a-6df2-41d6-b10e-70525f6cec5e
    Associated GPIs 60100060001010
    GCN Sequence Number 074169
    GCN Sequence Number Description phenobarbital ELIXIR 20 MG/5 ML ORAL
    HIC3 H2D
    HIC3 Description BARBITURATES
    GCN 38716
    HICL Sequence Number 001561
    HICL Sequence Number Description PHENOBARBITAL
    Brand/Generic Generic
    Proprietary Name Phenobarbital Oral Solution
    Proprietary Name Suffix n/a
    Non-Proprietary Name Phenobarbital Oral
    Product Type HUMAN PRESCRIPTION DRUG
    Dosage Form SOLUTION
    Route ORAL
    Active Ingredient Strength 20
    Active Ingredient Units mg/5mL
    Substance Name PHENOBARBITAL
    Labeler Name PAI Holdings, LLC
    Pharmaceutical Class n/a
    DEA Schedule CIV
    Marketing Category UNAPPROVED DRUG OTHER
    Application Number n/a
    Listing Certified Through 2024-12-31

    Package

    NDC 00121-0942-16 (00121094216)

    NDC Package Code 0121-0942-16
    Billing NDC 00121094216
    Package 473 mL in 1 BOTTLE, PLASTIC (0121-0942-16)
    Marketing Start Date 2021-08-20
    NDC Exclude Flag N
    Pricing Information
    Price Per Unit 0.05575
    Pricing Unit ML
    Effective Date 2024-02-21
    NDC Description PHENOBARBITAL 20 MG/5 ML SOLN
    Pharmacy Type Indicator C/I
    OTC N
    Explanation Code 1, 5
    Classification for Rate Setting G
    As of Date 2024-02-21
    This pricing file, entitled the NADAC (National Average Drug Acquisition Cost) files, provide state Medicaid agencies with covered outpatient drug prices by averaging survey invoice prices from retail community pharmacies across the United States. These pharmacies include independent retail community pharmacies and chain pharmacies. The prices are updated on a weekly and monthly basis