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    NDC 51759-0202-22 AJOVY 225 mg/1.5mL Details

    AJOVY 225 mg/1.5mL

    AJOVY is a SUBCUTANEOUS INJECTION in the HUMAN PRESCRIPTION DRUG category. It is labeled and distributed by Teva Pharmaceuticals USA, Inc.. The primary component is FREMANEZUMAB.

    Product Information

    NDC 51759-0202
    Product ID 51759-202_0ca1b7ee-c1d4-40cc-b545-34d9acf767ad
    Associated GPIs 6770203020D520
    GCN Sequence Number 080875
    GCN Sequence Number Description fremanezumab-vfrm AUTO INJCT 225 MG/1.5 SUBCUT
    HIC3 H3F
    HIC3 Description ANTIMIGRAINE PREPARATIONS
    GCN 47862
    HICL Sequence Number 045236
    HICL Sequence Number Description FREMANEZUMAB-VFRM
    Brand/Generic Brand
    Proprietary Name AJOVY
    Proprietary Name Suffix n/a
    Non-Proprietary Name fremanezumab-vfrm
    Product Type HUMAN PRESCRIPTION DRUG
    Dosage Form INJECTION
    Route SUBCUTANEOUS
    Active Ingredient Strength 225
    Active Ingredient Units mg/1.5mL
    Substance Name FREMANEZUMAB
    Labeler Name Teva Pharmaceuticals USA, Inc.
    Pharmaceutical Class n/a
    DEA Schedule n/a
    Marketing Category BLA
    Application Number BLA761089
    Listing Certified Through 2024-12-31

    Package

    NDC 51759-0202-22 (51759020222)

    NDC Package Code 51759-202-22
    Billing NDC 51759020222
    Package 3 CONTAINER in 1 CARTON (51759-202-22) / 1.5 mL in 1 CONTAINER
    Marketing Start Date 2020-08-31
    NDC Exclude Flag N
    Pricing Information
    Price Per Unit 427.73
    Pricing Unit ML
    Effective Date 2022-01-19
    NDC Description AJOVY 225 MG/1.5 ML AUTOINJECT
    Pharmacy Type Indicator C/I
    OTC N
    Explanation Code 4, 5
    Classification for Rate Setting B
    As of Date 2022-11-23
    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