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    NDC 50102-0231-13 Tri-VyLibra Lo Details

    Tri-VyLibra Lo

    Tri-VyLibra Lo is a KIT in the HUMAN PRESCRIPTION DRUG category. It is labeled and distributed by Afaxys Pharma, LLC. The primary component is .

    Product Information

    NDC 50102-0231
    Product ID 50102-231_bb0e872b-05ee-4e30-bc1f-808f2c533e5d
    Associated GPIs 25992002300310
    GCN Sequence Number 050831
    GCN Sequence Number Description norgestimate-ethinyl estradiol TABLET 7DAYSX3 LO ORAL
    HIC3 G8A
    HIC3 Description CONTRACEPTIVES,ORAL
    GCN 18126
    HICL Sequence Number 004845
    HICL Sequence Number Description NORGESTIMATE-ETHINYL ESTRADIOL
    Brand/Generic Generic
    Proprietary Name Tri-VyLibra Lo
    Proprietary Name Suffix n/a
    Non-Proprietary Name Norgestimate and Ethinyl Estradiol
    Product Type HUMAN PRESCRIPTION DRUG
    Dosage Form KIT
    Route n/a
    Active Ingredient Strength n/a
    Active Ingredient Units n/a
    Substance Name n/a
    Labeler Name Afaxys Pharma, LLC
    Pharmaceutical Class n/a
    DEA Schedule n/a
    Marketing Category ANDA
    Application Number ANDA205762
    Listing Certified Through 2024-12-31

    Package

    NDC 50102-0231-13 (50102023113)

    NDC Package Code 50102-231-13
    Billing NDC 50102023113
    Package 3 PACKAGE in 1 CARTON (50102-231-13) / 1 BLISTER PACK in 1 PACKAGE (50102-231-11) / 1 KIT in 1 BLISTER PACK (50102-231-01)
    Marketing Start Date 2016-11-04
    NDC Exclude Flag N
    Pricing Information
    Price Per Unit 0.12613
    Pricing Unit EA
    Effective Date 2024-02-21
    NDC Description TRI-VYLIBRA LO TABLET
    Pharmacy Type Indicator C/I
    OTC N
    Explanation Code 1
    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
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