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NDC 52709-1701-03 Odactra 6; 6 [arb'U]/1; [arb'U]/1 Details
Odactra 6; 6 [arb'U]/1; [arb'U]/1
Odactra is a SUBLINGUAL TABLET in the STANDARDIZED ALLERGENIC category. It is labeled and distributed by ALK-Abello A S. The primary component is DERMATOPHAGOIDES FARINAE; DERMATOPHAGOIDES PTERONYSSINUS.
Product Information
| NDC | 52709-1701 |
|---|---|
| Product ID | 52709-1701_1e822337-6296-4aa4-94b2-479fd3d9f217 |
| Associated GPIs | 20109902220740 |
| GCN Sequence Number | 076750 |
| GCN Sequence Number Description | mite,D.farinae-D.pteronyssinus TAB SUBL 12 SQ-HDM SUBLINGUAL |
| HIC3 | W7W |
| HIC3 Description | ALLERGENIC EXTRACTS, THERAPEUTIC |
| GCN | 42527 |
| HICL Sequence Number | 034376 |
| HICL Sequence Number Description | ALLERGENIC EXTRACT, MITE-D.FARINAE-D.PTERONYSSINUS,STANDARD |
| Brand/Generic | Brand |
| Proprietary Name | Odactra |
| Proprietary Name Suffix | n/a |
| Non-Proprietary Name | DERMATOPHAGOIDES PTERONYSSINUS and DERMATOPHAGOIDES FARINAE |
| Product Type | STANDARDIZED ALLERGENIC |
| Dosage Form | TABLET |
| Route | SUBLINGUAL |
| Active Ingredient Strength | 6; 6 |
| Active Ingredient Units | [arb'U]/1; [arb'U]/1 |
| Substance Name | DERMATOPHAGOIDES FARINAE; DERMATOPHAGOIDES PTERONYSSINUS |
| Labeler Name | ALK-Abello A S |
| Pharmaceutical Class | Allergens [CS], Allergens [CS], Antigens, Dermatophagoides [CS], Antigens, Dermatophagoides [CS], Cell-mediated Immunity [PE], Cell-mediated Immunity [PE], Increased Histamine Release [PE], Increased Histamine Release [PE], Increased IgG Production [PE], |
| DEA Schedule | n/a |
| Marketing Category | BLA |
| Application Number | BLA125592 |
| Listing Certified Through | 2024-12-31 |
Package
NDC 52709-1701-03 (52709170103)
| NDC Package Code | 52709-1701-3 |
|---|---|
| Billing NDC | 52709170103 |
| Package | 3 BLISTER PACK in 1 CARTON (52709-1701-3) / 10 TABLET in 1 BLISTER PACK (52709-1701-1) |
| Marketing Start Date | 2018-01-01 |
| NDC Exclude Flag | N |
| Pricing Information | |
| Price Per Unit | 11.0305 |
| Pricing Unit | EA |
| Effective Date | 2023-09-20 |
| NDC Description | ODACTRA 12 SQ-HDM SL TABLET |
| Pharmacy Type Indicator | C/I |
| OTC | N |
| Explanation Code | 2 |
| 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