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NDC 58657-0165-90 Multivitamin with Fluoride 15; 60; 4.5; 300; 13.5; 1.05; 1.2; 1; 1.05; 2500; 400 [iU]/1; mg/1; ug/1; ug/1; mg/1; mg/1; mg/1; mg/1; mg/1; [iU]/1; [iU]/1 Details
Multivitamin with Fluoride 15; 60; 4.5; 300; 13.5; 1.05; 1.2; 1; 1.05; 2500; 400 [iU]/1; mg/1; ug/1; ug/1; mg/1; mg/1; mg/1; mg/1; mg/1; [iU]/1; [iU]/1
Multivitamin with Fluoride is a ORAL TABLET, CHEWABLE in the HUMAN PRESCRIPTION DRUG category. It is labeled and distributed by Method Pharmaceuticals, LLC. The primary component is .ALPHA.-TOCOPHEROL ACETATE, DL-; ASCORBIC ACID; CYANOCOBALAMIN; FOLIC ACID; NIACIN; PYRIDOXINE; RIBOFLAVIN; SODIUM FLUORIDE; THIAMINE MONONITRATE; VITAMIN A; VITAMIN D.
Product Information
| NDC | 58657-0165 |
|---|---|
| Product ID | 58657-165_0c32e4de-2ef0-39ad-e063-6294a90a5bfe |
| Associated GPIs | 78441000000520 |
| GCN Sequence Number | 066017 |
| GCN Sequence Number Description | pedi multivit no.17 w-fluoride TAB CHEW 1 MG ORAL |
| HIC3 | C6H |
| HIC3 Description | PEDIATRIC VITAMIN PREPARATIONS |
| GCN | 28188 |
| HICL Sequence Number | 036833 |
| HICL Sequence Number Description | PEDIATRIC MULTIVITAMINS NO.17 WITH SODIUM FLUORIDE |
| Brand/Generic | Generic |
| Proprietary Name | Multivitamin with Fluoride |
| Proprietary Name Suffix | n/a |
| Non-Proprietary Name | .ALPHA.-TOCOPHEROL ACETATE, DL-, ASCORBIC ACID, CYANOCOBALAMIN, FOLIC ACID, NIACIN, PYRIDOXINE, RIBOFLAVIN, SODIUM FLUORIDE, THIAMINE MONONITRATE, VITAMIN A and VITAMIN D |
| Product Type | HUMAN PRESCRIPTION DRUG |
| Dosage Form | TABLET, CHEWABLE |
| Route | ORAL |
| Active Ingredient Strength | 15; 60; 4.5; 300; 13.5; 1.05; 1.2; 1; 1.05; 2500; 400 |
| Active Ingredient Units | [iU]/1; mg/1; ug/1; ug/1; mg/1; mg/1; mg/1; mg/1; mg/1; [iU]/1; [iU]/1 |
| Substance Name | .ALPHA.-TOCOPHEROL ACETATE, DL-; ASCORBIC ACID; CYANOCOBALAMIN; FOLIC ACID; NIACIN; PYRIDOXINE; RIBOFLAVIN; SODIUM FLUORIDE; THIAMINE MONONITRATE; VITAMIN A; VITAMIN D |
| Labeler Name | Method Pharmaceuticals, LLC |
| Pharmaceutical Class | Analogs/Derivatives [Chemical/Ingredient], Ascorbic Acid [CS], Nicotinic Acid [EPC], Nicotinic Acids [CS], Vitamin A [CS], Vitamin A [EPC], Vitamin B 12 [CS], Vitamin B 6 [Chemical/Ingredient], Vitamin B12 [EPC], Vitamin B6 Analog [EPC], Vitamin C [EPC] |
| DEA Schedule | n/a |
| Marketing Category | UNAPPROVED DRUG OTHER |
| Application Number | n/a |
| Listing Certified Through | 2024-12-31 |
Package
NDC 58657-0165-90 (58657016590)
| NDC Package Code | 58657-165-90 |
|---|---|
| Billing NDC | 58657016590 |
| Package | 90 TABLET, CHEWABLE in 1 BOTTLE (58657-165-90) |
| Marketing Start Date | 2018-07-20 |
| NDC Exclude Flag | N |
| Pricing Information | |
| Price Per Unit | 0.11499 |
| Pricing Unit | EA |
| Effective Date | 2024-02-21 |
| NDC Description | MULTIVIT-FLUORIDE 1 MG TAB CHW |
| 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