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NDC 00642-0093-30 Vitafol 9; 30; 330; 25; 2; 12; 200; 680; 29; 1020; 20; 15; 150; 2.5; 1.8; 1.6; 25 mg/1; mg/1; ug/1; ug/1; mg/1; ug/1; mg/1; ug/1; mg/1; ug/1; mg/1; mg/1; ug/1; mg/1; mg/1; mg/1; mg/1 Details
Vitafol 9; 30; 330; 25; 2; 12; 200; 680; 29; 1020; 20; 15; 150; 2.5; 1.8; 1.6; 25 mg/1; mg/1; ug/1; ug/1; mg/1; ug/1; mg/1; ug/1; mg/1; ug/1; mg/1; mg/1; ug/1; mg/1; mg/1; mg/1; mg/1
Vitafol is a ORAL CAPSULE, LIQUID FILLED in the HUMAN PRESCRIPTION DRUG category. It is labeled and distributed by Exeltis USA, Inc.. The primary component is .ALPHA.-TOCOPHEROL ACETATE, DL-; ASCORBIC ACID; BETA CAROTENE; CHOLECALCIFEROL; CUPRIC OXIDE; CYANOCOBALAMIN; DOCONEXENT; FOLIC ACID; IRON; LEVOMEFOLATE CALCIUM; MAGNESIUM OXIDE; NIACINAMIDE; POTASSIUM IODIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN; THIAMIN.
Product Information
| NDC | 00642-0093 |
|---|---|
| Product ID | 0642-0093_f6df2d91-9721-c396-e053-6394a90a48b0 |
| Associated GPIs | 78516058000130 |
| GCN Sequence Number | 071399 |
| GCN Sequence Number Description | PNV 67/iron ps/folate no.1/dha CAPSULE 29-1-200MG ORAL |
| HIC3 | C6F |
| HIC3 Description | PRENATAL VITAMIN PREPARATIONS |
| GCN | 35169 |
| HICL Sequence Number | 040586 |
| HICL Sequence Number Description | PRENATAL VIT NO.67/IRON POLYSACCHARIDES/FOLATE COMB.NO.1/DHA |
| Brand/Generic | Brand |
| Proprietary Name | Vitafol |
| Proprietary Name Suffix | Ultra |
| Non-Proprietary Name | Doconexent, Niacinamide, .Alpha.-Tocopherol Acetate, DL-, Cholecalciferol, .Beta.-Carotene, Ascorbic Acid, Thiamine Mononitrate, Riboflavin, Pyridoxine Hydrochloride, Cyanocobalamin, Iron, Zinc Oxide, Cupric Oxide, Potassium Iodide, Magnesium Oxide, Folic |
| Product Type | HUMAN PRESCRIPTION DRUG |
| Dosage Form | CAPSULE, LIQUID FILLED |
| Route | ORAL |
| Active Ingredient Strength | 9; 30; 330; 25; 2; 12; 200; 680; 29; 1020; 20; 15; 150; 2.5; 1.8; 1.6; 25 |
| Active Ingredient Units | mg/1; mg/1; ug/1; ug/1; mg/1; ug/1; mg/1; ug/1; mg/1; ug/1; mg/1; mg/1; ug/1; mg/1; mg/1; mg/1; mg/1 |
| Substance Name | .ALPHA.-TOCOPHEROL ACETATE, DL-; ASCORBIC ACID; BETA CAROTENE; CHOLECALCIFEROL; CUPRIC OXIDE; CYANOCOBALAMIN; DOCONEXENT; FOLIC ACID; IRON; LEVOMEFOLATE CALCIUM; MAGNESIUM OXIDE; NIACINAMIDE; POTASSIUM IODIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN; THIAMIN |
| Labeler Name | Exeltis USA, Inc. |
| Pharmaceutical Class | Analogs/Derivatives [Chemical/Ingredient], Ascorbic Acid [CS], Calculi Dissolution Agent [EPC], Folate Analog [EPC], Folic Acid [CS], Increased Large Intestinal Motility [PE], Inhibition Large Intestine Fluid/Electrolyte Absorption [PE], Inhibition Small |
| DEA Schedule | n/a |
| Marketing Category | UNAPPROVED DRUG OTHER |
| Application Number | n/a |
| Listing Certified Through | 2024-12-31 |
Package
NDC 00642-0093-30 (00642009330)
| NDC Package Code | 0642-0093-30 |
|---|---|
| Billing NDC | 00642009330 |
| Package | 5 BLISTER PACK in 1 BOX (0642-0093-30) / 6 CAPSULE, LIQUID FILLED in 1 BLISTER PACK |
| Marketing Start Date | 2013-09-23 |
| NDC Exclude Flag | N |
| Pricing Information | |
| Price Per Unit | 4.24771 |
| Pricing Unit | EA |
| Effective Date | 2024-01-15 |
| NDC Description | VITAFOL ULTRA SOFTGEL |
| Pharmacy Type Indicator | C/I |
| OTC | N |
| Explanation Code | 4, 6 |
| 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