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NDC 15370-0250-30 TriStart DHA 15; 55; 1000; 14; 200; 400; 15; 31; 600; 30; 5; 200; 35; 1.8; 1.3 [iU]/1; mg/1; [iU]/1; ug/1; mg/1; ug/1; mg/1; mg/1; ug/1; mg/1; mg/1; ug/1; mg/1; mg/1; mg/1 Details
TriStart DHA 15; 55; 1000; 14; 200; 400; 15; 31; 600; 30; 5; 200; 35; 1.8; 1.3 [iU]/1; mg/1; [iU]/1; ug/1; mg/1; ug/1; mg/1; mg/1; ug/1; mg/1; mg/1; ug/1; mg/1; mg/1; mg/1
TriStart DHA is a ORAL CAPSULE, LIQUID FILLED in the HUMAN PRESCRIPTION DRUG category. It is labeled and distributed by CarWin Pharmaceutical Associates, LLC. The primary component is .ALPHA.-TOCOPHEROL ACETATE, D-; ASCORBIC ACID; CHOLECALCIFEROL; CYANOCOBALAMIN; DOCONEXENT; FOLIC ACID; ICOSAPENT; IRON PENTACARBONYL; LEVOMEFOLATE MAGNESIUM; MAGNESIUM OXIDE; NIACIN; POTASSIUM IODIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROC.
Product Information
| NDC | 15370-0250 |
|---|---|
| Product ID | 15370-250_4889480e-2d59-4dbd-a808-ea7fce24f922 |
| Associated GPIs | 78516023000140 |
| GCN Sequence Number | 074232 |
| GCN Sequence Number Description | prenatal 93/iron/folate 9/dha CAPSULE 31-1-200MG ORAL |
| HIC3 | C6F |
| HIC3 Description | PRENATAL VITAMIN PREPARATIONS |
| GCN | 38736 |
| HICL Sequence Number | 042128 |
| HICL Sequence Number Description | PRENATAL VITAMINS NO.93/IRON CARBONYL/FOLATE COMB NO.9/DHA |
| Brand/Generic | Brand |
| Proprietary Name | TriStart DHA |
| Proprietary Name Suffix | n/a |
| Non-Proprietary Name | ASCORBIC ACID, CHOLECALCIFEROL, .ALPHA.-TOCOPHEROL ACETATE, D-, THIAMINE HYDROCHLORIDE, RIBOFLAVIN, NIACIN, PYRIDOXINE HYDROCHLORIDE, LEVOMEFOLATE MAGNESIUM, FOLIC ACID, CYANOCOBALAMIN, IRON PENTACARBONYL, POTASSIUM IODIDE, MAGNESIUM OXIDE, DOCONEXENT, an |
| Product Type | HUMAN PRESCRIPTION DRUG |
| Dosage Form | CAPSULE, LIQUID FILLED |
| Route | ORAL |
| Active Ingredient Strength | 15; 55; 1000; 14; 200; 400; 15; 31; 600; 30; 5; 200; 35; 1.8; 1.3 |
| Active Ingredient Units | [iU]/1; mg/1; [iU]/1; ug/1; mg/1; ug/1; mg/1; mg/1; ug/1; mg/1; mg/1; ug/1; mg/1; mg/1; mg/1 |
| Substance Name | .ALPHA.-TOCOPHEROL ACETATE, D-; ASCORBIC ACID; CHOLECALCIFEROL; CYANOCOBALAMIN; DOCONEXENT; FOLIC ACID; ICOSAPENT; IRON PENTACARBONYL; LEVOMEFOLATE MAGNESIUM; MAGNESIUM OXIDE; NIACIN; POTASSIUM IODIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROC |
| Labeler Name | CarWin Pharmaceutical Associates, LLC |
| 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 | 2025-12-31 |
Package
NDC 15370-0250-30 (15370025030)
| NDC Package Code | 15370-250-30 |
|---|---|
| Billing NDC | 15370025030 |
| Package | 30 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (15370-250-30) |
| Marketing Start Date | 2015-06-01 |
| NDC Exclude Flag | N |
| Pricing Information | |
| Price Per Unit | 8.77906 |
| Pricing Unit | EA |
| Effective Date | 2023-03-03 |
| NDC Description | TRISTART DHA 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