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    NDC 00169-4314-30 RYBELSUS 14 mg/1 Details

    RYBELSUS 14 mg/1

    RYBELSUS is a ORAL TABLET in the HUMAN PRESCRIPTION DRUG category. It is labeled and distributed by Novo Nordisk. The primary component is SEMAGLUTIDE.

    Product Information

    NDC 00169-4314
    Product ID 0169-4314_fa74bbc6-5386-425e-8d4a-6151795ba57b
    Associated GPIs 27170070000330
    GCN Sequence Number 080230
    GCN Sequence Number Description semaglutide TABLET 14 MG ORAL
    HIC3 C4I
    HIC3 Description ANTIHYPERGLY,INCRETIN MIMETIC(GLP-1 RECEP.AGONIST)
    GCN 46966
    HICL Sequence Number 044675
    HICL Sequence Number Description SEMAGLUTIDE
    Brand/Generic Brand
    Proprietary Name RYBELSUS
    Proprietary Name Suffix n/a
    Non-Proprietary Name Oral Semaglutide
    Product Type HUMAN PRESCRIPTION DRUG
    Dosage Form TABLET
    Route ORAL
    Active Ingredient Strength 14
    Active Ingredient Units mg/1
    Substance Name SEMAGLUTIDE
    Labeler Name Novo Nordisk
    Pharmaceutical Class GLP-1 Receptor Agonist [EPC], Glucagon-Like Peptide 1 [CS], Glucagon-like Peptide-1 (GLP-1) Agonists [MoA]
    DEA Schedule n/a
    Marketing Category NDA
    Application Number NDA213051
    Listing Certified Through 2024-12-31

    Package

    NDC 00169-4314-30 (00169431430)

    NDC Package Code 0169-4314-30
    Billing NDC 00169431430
    Package 30 TABLET in 1 BOTTLE, GLASS (0169-4314-30)
    Marketing Start Date 2021-10-04
    NDC Exclude Flag N
    Pricing Information
    Price Per Unit 31.0842
    Pricing Unit EA
    Effective Date 2024-01-01
    NDC Description RYBELSUS 14 MG TABLET
    Pharmacy Type Indicator C/I
    OTC N
    Explanation Code 4
    Classification for Rate Setting B
    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