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    NDC 58657-0500-04 Codeine-Guaifenesin 10; 100 mg/5mL; mg/5mL Details

    Codeine-Guaifenesin 10; 100 mg/5mL; mg/5mL

    Codeine-Guaifenesin is a ORAL SOLUTION in the HUMAN OTC DRUG category. It is labeled and distributed by Method Pharmaceuticals, LLC. The primary component is CODEINE PHOSPHATE; GUAIFENESIN.

    Product Information

    NDC 58657-0500
    Product ID 58657-500_0c5a0409-72fe-dd9b-e063-6394a90ae6a7
    Associated GPIs 43997002282020
    GCN Sequence Number 045669
    GCN Sequence Number Description codeine phosphate/guaifenesin LIQUID 10-100MG/5 ORAL
    HIC3 B4S
    HIC3 Description OPIOID ANTITUSSIVE-EXPECTORANT COMBINATION
    GCN 91713
    HICL Sequence Number 000206
    HICL Sequence Number Description CODEINE PHOSPHATE/GUAIFENESIN
    Brand/Generic Generic
    Proprietary Name Codeine-Guaifenesin
    Proprietary Name Suffix n/a
    Non-Proprietary Name Codeine Phosphate and Guaifenesin
    Product Type HUMAN OTC DRUG
    Dosage Form SOLUTION
    Route ORAL
    Active Ingredient Strength 10; 100
    Active Ingredient Units mg/5mL; mg/5mL
    Substance Name CODEINE PHOSPHATE; GUAIFENESIN
    Labeler Name Method Pharmaceuticals, LLC
    Pharmaceutical Class Decreased Respiratory Secretion Viscosity [PE], Expectorant [EPC], Full Opioid Agonists [MoA], Increased Respiratory Secretions [PE], Opioid Agonist [EPC]
    DEA Schedule CV
    Marketing Category OTC MONOGRAPH DRUG
    Application Number M012
    Listing Certified Through 2024-12-31

    Package

    NDC 58657-0500-04 (58657050004)

    NDC Package Code 58657-500-04
    Billing NDC 58657050004
    Package 120 mL in 1 BOTTLE (58657-500-04)
    Marketing Start Date 2014-04-01
    NDC Exclude Flag N
    Pricing Information
    Price Per Unit 0.04828
    Pricing Unit ML
    Effective Date 2024-02-21
    NDC Description CODEINE-GUAIFEN 10-100 MG/5 ML
    Pharmacy Type Indicator C/I
    OTC Y
    Explanation Code 1, 5
    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