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NDC 58657-0454-01 Me NaPhos MB Hyo 1 .12; 81.6; 10.8; 40.8 mg/1; mg/1; mg/1; mg/1 Details
Me NaPhos MB Hyo 1 .12; 81.6; 10.8; 40.8 mg/1; mg/1; mg/1; mg/1
Me NaPhos MB Hyo 1 is a ORAL TABLET in the HUMAN PRESCRIPTION DRUG category. It is labeled and distributed by Method Pharmaceuticals. The primary component is HYOSCYAMINE SULFATE ANHYDROUS; METHENAMINE; METHYLENE BLUE ANHYDROUS; SODIUM PHOSPHATE, MONOBASIC, MONOHYDRATE.
Product Information
| NDC | 58657-0454 |
|---|---|
| Product ID | 58657-454_0c1cc5ba-7438-062d-e063-6294a90ae544 |
| Associated GPIs | 16992004200325 |
| GCN Sequence Number | 066593 |
| GCN Sequence Number Description | methenam/sod phos/mblue/hyoscy TABLET 81.6-.12MG ORAL |
| HIC3 | W2G |
| HIC3 Description | ANTIBIOTIC, ANTIBACTERIAL, MISC. |
| GCN | 28868 |
| HICL Sequence Number | 037115 |
| HICL Sequence Number Description | METHENAMINE/SOD PHOSPH,MONOBASIC/METHYLENE BLUE/HYOSCYAMINE |
| Brand/Generic | Generic |
| Proprietary Name | Me NaPhos MB Hyo 1 |
| Proprietary Name Suffix | n/a |
| Non-Proprietary Name | Urinary Antiseptic Antispasmodic |
| Product Type | HUMAN PRESCRIPTION DRUG |
| Dosage Form | TABLET |
| Route | ORAL |
| Active Ingredient Strength | .12; 81.6; 10.8; 40.8 |
| Active Ingredient Units | mg/1; mg/1; mg/1; mg/1 |
| Substance Name | HYOSCYAMINE SULFATE ANHYDROUS; METHENAMINE; METHYLENE BLUE ANHYDROUS; SODIUM PHOSPHATE, MONOBASIC, MONOHYDRATE |
| Labeler Name | Method Pharmaceuticals |
| Pharmaceutical Class | Oxidation-Reduction Activity [MoA], Oxidation-Reduction Agent [EPC] |
| DEA Schedule | n/a |
| Marketing Category | UNAPPROVED DRUG OTHER |
| Application Number | n/a |
| Listing Certified Through | 2024-12-31 |
Package
NDC 58657-0454-01 (58657045401)
| NDC Package Code | 58657-454-01 |
|---|---|
| Billing NDC | 58657045401 |
| Package | 100 TABLET in 1 BOTTLE (58657-454-01) |
| Marketing Start Date | 2015-12-01 |
| NDC Exclude Flag | N |
| Pricing Information | |
| Price Per Unit | 3.58102 |
| Pricing Unit | EA |
| Effective Date | 2024-01-17 |
| NDC Description | ME-NAPHOS-MB-HYO 1 TABLET |
| Pharmacy Type Indicator | C/I |
| OTC | N |
| Explanation Code | 4 |
| 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