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    NDC 65628-0206-05 FIRVANQ Details

    FIRVANQ

    FIRVANQ is a KIT in the HUMAN PRESCRIPTION DRUG category. It is labeled and distributed by Azurity Pharmaceuticals, Inc. The primary component is .

    Product Information

    NDC 65628-0206
    Product ID 65628-206_0c018d41-1802-4500-e063-6394a90a2ef2
    Associated GPIs 16280080102170
    GCN Sequence Number 009333
    GCN Sequence Number Description vancomycin HCl SOLN RECON 50 MG/ML ORAL
    HIC3 W1J
    HIC3 Description VANCOMYCIN ANTIBIOTICS AND DERIVATIVES
    GCN 41291
    HICL Sequence Number 004042
    HICL Sequence Number Description VANCOMYCIN HCL
    Brand/Generic Brand
    Proprietary Name FIRVANQ
    Proprietary Name Suffix n/a
    Non-Proprietary Name vancomycin hydrochloride
    Product Type HUMAN PRESCRIPTION DRUG
    Dosage Form KIT
    Route n/a
    Active Ingredient Strength n/a
    Active Ingredient Units n/a
    Substance Name n/a
    Labeler Name Azurity Pharmaceuticals, Inc
    Pharmaceutical Class n/a
    DEA Schedule n/a
    Marketing Category NDA
    Application Number NDA208910
    Listing Certified Through 2024-12-31

    Package

    NDC 65628-0206-05 (65628020605)

    NDC Package Code 65628-206-05
    Billing NDC 65628020605
    Package 1 KIT in 1 CARTON (65628-206-05) * 7.5 g in 1 BOTTLE * 145 mL in 1 BOTTLE
    Marketing Start Date 2018-01-26
    NDC Exclude Flag N
    Pricing Information
    Price Per Unit 0.94002
    Pricing Unit ML
    Effective Date 2022-10-01
    NDC Description FIRVANQ 50 MG/ML SOLUTION
    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