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    NDC 66689-0307-08 Mycophenolate Mofetil 200 mg/mL Details

    Mycophenolate Mofetil 200 mg/mL

    Mycophenolate Mofetil is a ORAL POWDER, FOR SUSPENSION in the HUMAN PRESCRIPTION DRUG category. It is labeled and distributed by VistaPharm, LLC. The primary component is MYCOPHENOLATE MOFETIL.

    Product Information

    NDC 66689-0307
    Product ID 66689-307_5cd07ba1-653b-48cc-9761-337112ec05e9
    Associated GPIs 99403030101920
    GCN Sequence Number 041845
    GCN Sequence Number Description mycophenolate mofetil SUSP RECON 200 MG/ML ORAL
    HIC3 Z2E
    HIC3 Description IMMUNOSUPPRESSIVES
    GCN 47563
    HICL Sequence Number 010012
    HICL Sequence Number Description MYCOPHENOLATE MOFETIL
    Brand/Generic Generic
    Proprietary Name Mycophenolate Mofetil
    Proprietary Name Suffix n/a
    Non-Proprietary Name Mycophenolate Mofetil
    Product Type HUMAN PRESCRIPTION DRUG
    Dosage Form POWDER, FOR SUSPENSION
    Route ORAL
    Active Ingredient Strength 200
    Active Ingredient Units mg/mL
    Substance Name MYCOPHENOLATE MOFETIL
    Labeler Name VistaPharm, LLC
    Pharmaceutical Class Antimetabolite Immunosuppressant [EPC]
    DEA Schedule n/a
    Marketing Category ANDA
    Application Number ANDA210370
    Listing Certified Through 2024-12-31

    Package

    NDC 66689-0307-08 (66689030708)

    NDC Package Code 66689-307-08
    Billing NDC 66689030708
    Package 1 BOTTLE, PLASTIC in 1 CARTON (66689-307-08) / 250 mL in 1 BOTTLE, PLASTIC
    Marketing Start Date 2019-02-15
    NDC Exclude Flag N
    Pricing Information
    Price Per Unit 1.84953
    Pricing Unit ML
    Effective Date 2024-02-21
    NDC Description MYCOPHENOLATE 200 MG/ML SUSP
    Pharmacy Type Indicator C/I
    OTC N
    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