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BETASEPT Antiseptic Surgical Scrub .04 mg/mL Solution, 473 mL — NDC 67618-0200-16 package photo
Label image from the product's FDA listing (DailyMed) — may show a different pack size or an older label revision.

BETASEPT Antiseptic Surgical Scrub .04 mg/mL Solution, 473 mL — NDC 67618-200-16 (Billing 67618-0200-16)

by Atlantis Consumer Healthcare, Inc. · 473 mL in 1 BOTTLE

This is a package of 473 mL of BETASEPT Antiseptic Surgical Scrub .04 mg/mL Solution from Atlantis Consumer Healthcare, Inc., marketed since Jun 1993 and currently FDA-listed; retail pharmacies pay about $0.0178 per mL (NADAC).

NDC 67618-0200-16
🏷️ FDA NDC (as labeled) 67618-200-16 billing pads the product segment with a zero
This package
Contains473 mL Cost per mL$0.0178 NADAC Per package$8.42 / 473 ml Pack sizes5 compare ↓
Also priced by: Medicaid pays $0.0353/unit — full pricing hub ↓
Product page 67618-0200-08 Also comes in: 118 ml 67618-200-04 237 ml 67618-200-08 946 ml 67618-200-30 946 ml 67618-200-32
OTC Brand On market Non-controlled ⇄ Compare with another NDC
🗂️ FDA directory synced Oct 1, 2026 · this listing last changed Jul 24, 2026 · sources: openFDA · FDA label (DailyMed) · FDA Orange & Purple Book · First Databank · CMS NADAC, ASP, Medicare & Medicaid · RxNorm
📋 All sources & update times →

This page is curated, coded, and maintained by

Compiled from public FDA, CMS, DailyMed, NADAC, and related drug data sources. Editorial policy

NDC database record

One package, one record: these facts belong to NDC 67618-200-16 alone.

Record
FDA NDC Directory package listing · Human OTC drug
Code segments
67618 labeler · 200 product · 16 package
Package marketed since
Jun 1, 1993
Sample package
No — commercial package
Listing certified through
Dec 31, 2026
Billing quantity
473 mL per package
Barcode (UPC-A, from the NDC)
3 6761820016 2
Medicaid fills, this package
729 prescriptions in the last four reported quarters
FDA record last changed
Jul 24, 2026

Identity & classification

Regulatory identifiers FDA, NLM and CMS codes for this package

FDA NDC (as labeled) 67618-200-16
Product NDC 67618-200
11-digit billing NDC 67618020016
NCPDP billing unit ML — per mL (volume)
RxCUI 211365, 834150
UNII MOR84MUD8E
Application # NDA019125
SPL Set ID 7e64e7bf-e88f-4056-c9e1-b49a277daa6c
Physiologic effect Decreased Cell Wall Integrity
DEA schedule Non-controlled
Marketing category NDA
Marketing status On market
FDA listing status Listed (active directory)
Marketing start 1993-06-01
Route TOPICAL
Dosage form SOLUTION
Substance CHLORHEXIDINE GLUCONATE

Drug-database identifiers Medi-Span GPI and First Databank GCN / HICL / AHFS classification

GPI-14 92100030102020
GPI class Betasept Surgical Scrub
GCN Seq No 007254
GCN 30011
HICL code 004297
Ingredient (HICL) Chlorhexidine Gluconate
HIC1 code Q
Therapeutic class — broad (HIC1) Ear/Eye/Nose/Rectum/Topical/Vagina/Other
HIC2 code Q5
Therapeutic class — intermediate (HIC2) Agents Acting Principally On The Skin
HIC3 code Q5B
Therapeutic class — specific (HIC3) Topical Preparations,Antibacterials
AHFS code 08:30.04.00
AHFS class Amebicides
FDB label name BETASEPT 4% SURGICAL SCRUB
FDB brand name Betasept
Legend status O — Over-the-counter (OTC) drug or device
Quick answers
  • GSN (GCN sequence number): 007254
  • GCN: 30011
  • GPI-14 (Medi-Span): 92100030102020
  • HICL (First Databank): 004297
  • AHFS class code: 08:30.04.00
  • RxCUI (RxNorm): 211365
Why two NDCs? The FDA registers this code as 67618-200-16 — a 5-3-2 layout, and that's what's printed on the package and shown on DailyMed. For insurance claims, every NDC is standardized to a uniform 11-digit 5-4-2 format by adding a zero to the product segment → 67618-0200-16. Same drug, same package — only the format differs.
Where does this data come from?
Identifiers from the FDA openFDA NDC Directory and Structured Product Labeling; RxCUI from RxNorm (NLM); GPI from Medi-Span; GCN / HIC / AHFS / legend from First Databank.

RxNorm drug class

This medicine belongs to the Antiinfectives and antiseptics for local oral treatment class.

Drug family (ATC) Antiinfectives and antiseptics for local oral treatment, Antiinfectives, Biguanides and amidines
Where does this data come from?
Therapeutic classes from RxNorm RxClass (U.S. National Library of Medicine) — Established Pharmacologic Class (FDA), ATC drug family (WHO) and mechanism of action, matched by this product’s RxCUI.

Clinical

Label name BETASEPT 4% SURGICAL SCRUB Ingredient Chlorhexidine Gluconate
📗 Our plain-language guide HelloPharmacist
  • It treats gingivitis, which means red, swollen gums that may bleed. You use it between dental visits as part of a program with your dentist. It has not been tested in people with A...
  • It can. Staining of teeth and other mouth surfaces is one of the most common side effects. You may also notice more tartar and changes in taste. Your dentist should remove tartar a...
  • Anyone allergic to chlorhexidine gluconate or any ingredient in the product should avoid it. Serious allergic reactions, including anaphylaxis, have been reported with dental produ...
  • Keep it out of reach of children. A small child who swallows 1 or 2 ounces may have stomach upset, nausea or signs of alcohol intoxication. Get medical help if more than 4 ounces i...
📖 Read our full Chlorhexidine guide →

Supplement & herbal interactions

🌿 Drug–supplement interaction checker →
Where does this data come from?
Plain-language summary from MedlinePlus (U.S. National Library of Medicine); supplement & herbal interactions and nutrient depletion data from the Natural Medicines database; our full guide is HelloPharmacist editorial content.

Pricing

A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.

Price systemPer mLPer package
Retail pharmacies payNADAC · weekly $0.018 $8.42 / 473 ml
Medicaid paysCMS SDUD · 12 mo $0.0353 $16.70 / 473 ml
Medicare drug plans payPart D · quarterly No Part D plan price is available for this NDC in our data.
NADAC price history (per mL) — tap or hover for the price & month
Nov 2021 Sep 2022 Feb 2026 Sep 2026 $0.023 $0.014
▲ Up 14% over the last 20 months.
Where does this data come from?
NADAC (National Average Drug Acquisition Cost) is the CMS weekly pharmacy-acquisition-cost survey — what pharmacies pay. ASP (Average Sales Price) is the CMS Medicare Part B drug-payment file, published quarterly. Medicaid pays is computed by us from CMS State Drug Utilization Data (total reimbursed ÷ units, trailing 12 months) — gross of rebates and inclusive of dispensing fees, so it reflects what Medicaid paid, not an acquisition cost. Medicare drug plans pay is the median negotiated point-of-sale unit cost across plans listing this NDC in the CMS quarterly Prescription Drug Plan pricing files, before rebates. The VA pays is the federal contract price (FSS, and the statutory Big 4 ceiling where listed) from the VA National Acquisition Center pharmaceutical price file. All are free public government data; each measures a different payer, so the figures are not directly comparable.

Packaging — all sizes for this product

Package NDCDescription Per unit Per pack Marketing startMarketing endStatus
67618-0200-04 67618-200-04 118 mL in 1 BOTTLE $0.0399 / mL $4.71 1993-06-01 — Active
67618-0200-08 67618-200-08 Main listing 237 mL in 1 BOTTLE $0.0366 / mL $8.68 1993-06-01 — Active
67618-0200-16 You're viewing this 473 mL in 1 BOTTLE $0.0178 / mL $8.40 1993-06-01 — Active
67618-0200-30 67618-200-30 946 mL in 1 BOTTLE — — 1993-06-01 — Active
67618-0200-32 67618-200-32 946 mL in 1 BOTTLE — — 1993-06-01 — Discontinued by firm

This pack has the lowest per-mL cost of the 3 priced pack sizes ($0.0178 NADAC).

This pack accounts for about 29% of this product's recent Medicaid fills; the largest share goes to the 237 ml pack. See all packs ↓

Pack size FAQ

What quantity is in this package?
This package contains 473 mL — 473 ml in 1 bottle.
How does this package differ from NDC 67618-0200-04?
Both are BETASEPT Antiseptic Surgical Scrub .04 mg/mL Solution — the drug itself is identical. This page's package is the 473 mL one, while NDC 67618-0200-04 is the 118 ml package. Per-mL NADAC also differs: $0.0178 here vs $0.0399 for the 118 ml pack.
What NDC number is used to bill for this package of BETASEPT Antiseptic Surgical Scrub .04 mg/mL Solution?
Use the 11-digit billing form listed in the identifiers section of this page. Pharmacy and medical claims use the 11-digit form; the FDA label may print a shorter form of the same code.

Prices are the latest CMS NADAC pharmacy acquisition cost per NDC; per-pack figures are per-unit × pack quantity, shown only when the pack is denominated in the same measure NADAC prices.

Therapeutic equivalents

ProductLabelerPackNADAC/unitTEStatusPrice vs. this
Betasept .04 mg/mLthis 67618-0200-16 Atlantis 473 ml $0.018 — Availability likely —
Antiseptic Skin Cleanser 4 g/100mL 70000-0407-01 Cardinal 237 ml $0.025 — FDA listed +43%
Antiseptic Skin Cleanser 4 g/100mL 00116-1061-04 Xttrium 118 ml $0.034 — Availability likely +90%
Antiseptic Skin Cleanser 4 mg/100mL 46122-0137-34 AmerisourceBergen 237 ml $0.037 — Availability likely +106%
Foster and Thrive 4 g/100mL 70677-1221-01 McKesson 237 ml $0.037 — Availability likely +106%
Chlorhexidine Gluconate 40 mg/mL 16571-0111-12 Rising 118 ml $0.040 — Availability likely +125%
Cardinal Health 4 g/100mL 00116-0061-04 Xttrium 118 ml — — Discontinued —
Antiseptic Skin Cleanser 4 mg/100mL 00116-0137-34 Xttrium 237 ml — — FDA listed —
Antiseptic Skin Cleanser 4 mg/100mL 00116-0161-08 Xttrium 237 ml — — FDA listed —
Betasept .04 mg/mL 00116-0200-01 Xttrium 3785 ml — — FDA listed —
Antiseptic Skin Cleanser 4 mg/100mL 00116-0401-50 Xttrium 237 ml — — FDA listed —
Antiseptic Skin Cleanser 4 g/100mL 00116-0407-01 Xttrium 237 ml — — FDA listed —
Antiseptic Skin Cleanser 4 g/100mL 00116-0767-08 Xttrium 237 ml — — FDA listed —
CliniClean 4 g/100mL 00116-0901-05 Xttrium 118 ml — — Discontinued —
Dyna-Hex 4 4 g/100mL 00116-1060-18 Xttrium 535 ml — — FDA listed —
Foster and Thrive 4 g/100mL 00116-1221-01 Xttrium 237 ml — — FDA listed —
Bactoshield CHG 40 mg/mL 00116-1344-08 Xttrium 3780 ml — — FDA listed —
Antiseptic Skin Cleanser 4 mg/100mL 00116-3678-07 Xttrium 473 ml — — FDA listed —
Hibiclens 4 g/100mL 00234-0575-40 Molnlycke 118 ml — — FDA listed —
Antiseptic Skin Cleanser 4 mg/100mL 00363-1061-08 Walgreen 237 ml — — FDA listed —
Maxiclens Chlorhexidine Gluconate Liquid Solution, 4% 40 mg/mL 00404-0219-01 Henry 118 ml — — FDA listed —
Maxiclens Chlorhexidine Gluconate Liquid Solution, 4% 40 mg/mL 00404-0220-03 Henry 236 ml — — FDA listed —
Maxiclens Chlorhexidine Gluconate Liquid Solution, 4% 40 mg/mL 00404-0221-04 Henry 473 ml — — FDA listed —
Bactoshield CHG 40 mg/mL 11084-0039-03 SC 118 ml — — FDA listed —
Bactoshield CHG 40 mg/mL 11084-0128-03 SC 118 ml — — FDA listed —
Antiseptic Skin Cleanser 4 g/100mL 11822-0116-05 Rite 237 ml — — FDA listed —
Antiseptic Skin Cleanser 4 g/100mL 11822-0891-02 Rite 532 ml — — FDA listed —
Antiseptic Skin Cleanser 4 mg/100mL 11822-3678-07 Rite 473 ml — — FDA listed —
BD E-Z Scrub 107 40 g/1000mL 17271-0107-03 Becton 18 ml — — FDA listed —
Antiseptic Skin Cleanser 4 mg/100mL 36800-0401-50 Topco 237 ml — — FDA listed —
Halyard Chlorhexidine Gluconate 40 mg/mL 39892-0960-01 Owens 118 ml — — FDA listed —
Halyard Chlorhexidine Gluconate 40 mg/mL 39892-0961-01 Owens 118 ml — — FDA listed —
Antiseptic Skin Cleanser 4 mg/100mL 41250-0162-08 Meijer 237 ml — — Discontinued —
Scrub, Scrub-Stat, Foam Safe, Micro-Guard 40 mg/mL 42939-0125-19 AVA, 946 ml — — FDA listed —
Scrub, Scrub-Stat, Foam Safe, Micro-Guard 40 mg/mL 42939-0128-01 AVA, 118 ml — — FDA listed —
Scrub-Stat 40 mg/mL 47593-0464-11 Ecolab 3780 ml — — FDA listed —
Scrub-Stat 40 mg/mL 47593-0468-21 Ecolab 208000 ml — — Discontinued —
Antiseptic Skin Cleanser 4 g/100mL 59779-0767-08 CVS 237 ml — — FDA listed —
Antiseptic Skin Cleanser 4 mg/100mL 63868-0940-08 Chain 237 ml — — FDA listed —
Antiseptic Skin Cleanser 4 g/100mL 68599-5401-00 McKesson 4 bottles — — FDA listed —
CliniClean 4 g/100mL 69464-0901-05 HR 118 ml — — Discontinued —
Hibiclens 4 g/100mL 76420-0535-08 Asclemed 236 ml — — FDA listed —
Surgical Scrub Brush/Sponge With Nail Cleaner 4% CHG 4 g/100mL 84128-0003-01 Xinxiang 30 patches — — FDA listed —
About this product: this is the brand-name version. Some generic versions are approved by the FDA, but we could not confirm current pharmacy availability from our pricing/market data.
Where does this data come from?
Equivalents are other NDCs of the same ingredient, form and route from the openFDA NDC Directory, ranked least-expensive-first by NADAC. Therapeutic-equivalence (AB) ratings come from the FDA Orange Book; biologics use the FDA Purple Book for biosimilar & interchangeable status.

Availability & generic status

🏛️
1993
On the market since
Jun 1993
📍
2026
Currently FDA-listed
33 years listed
🔒
·
Generic approved (availability unconfirmed)
see note
🔒Generic approved by FDA, but pharmacy availability is not confirmed

The FDA lists approved generic versions of this medicine, but that does not always mean a pharmacy can get one today. Patent rules, launch agreements, supply and pricing can affect when generics actually arrive.

Where does this data come from?
Patents and exclusivity from the FDA Orange Book (small-molecule drugs), refreshed from public FDA data. Generic launch timing is an estimate, not a guarantee.

Inactive Ingredients / Excipients

Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.

💡 Tap an ingredient (hover on desktop) to see what it is and why it’s used.

  • UNII 92005F972D
    A foaming and thickening agent derived from coconut oil. It's used in liquid medicines to improve texture, help distribute active ingredients evenly, and create a pleasant consistency for easier swallowing or application.
  • UNII WQ29KQ9POT
    Gluconolactone is a mild organic acid derived from glucose. It functions as a buffer and pH regulator in medicines, helping maintain stable acidity levels and improve product stability.
  • UNII S38J6RZN16
    Hydroxyethyl cellulose is a plant-derived thickening agent made from cellulose. In medicines, it acts as a binder to hold ingredients together, a thickener to adjust product texture, and a film-former to create smooth coatings on tablets.
  • UNII ND2M416302
    Isopropyl alcohol is a clear liquid solvent derived from petroleum. In medicines, it dissolves active ingredients and other components, helps the product flow smoothly, and aids in sterilization during manufacturing.
  • UNII 4F6FC4MI8W
    Lauramine oxide is a surfactant, a substance that helps mix oil and water together. It's used in medicines to improve how ingredients blend and to help the product dissolve or spread properly.
  • UNII 09179OX7TB
    PEG-75 Lanolin is a waxy substance derived from sheep's wool that has been chemically modified to mix easily with water and oil. It acts as an emulsifier and moisturizer in topical formulations, helping blend different ingredients and soften the skin.
  • UNII 8I9428H868
    Tridecyl alcohol is a fatty alcohol derived from natural oils or made synthetically. In medicines, it works as an emulsifier and surfactant to help mix oil and water-based ingredients together smoothly.
  • UNII 059QF0KO0R
    Water is a liquid solvent that dissolves and mixes ingredients together in liquid medicines, syrups, and injections. It helps distribute the active drug evenly throughout the product.

8 inactive ingredients listed in the exact product block matched to this NDC.

The official label also statesInactive ingredients cocamide DEA, fragrance, glucono-delta-lactone, hydroxyethylcellulose, isopropyl alcohol, lauramine oxide, PEG-75 lanolin, purified water, tridecyl alcohol Questions or comments? call 1-888-827-0624 (8am-5pm, EST, Mon-Fri.) WARNING: This product can expose you to chemicals including coconut oil diethanolamine condensate (cocamide diethanolamine), which is known to the State of California to cause cancer. For more information go to www.P65Warnings.ca.gov Dist. by: Avrio Health L.P. Stamford, CT 06901-3431 304978-0A

Label-section wording can be broader than the structured product block and may mention additional formulation ingredients.

Where does this data come from?
Data sourced from official FDA Structured Product Labeling (SPL) via DailyMed — ingredient classCode="IACT" elements from the exact product block matched by this NDC. Label-section narrative from DailyMed / the openFDA label index is shown separately when available.

Inactive ingredient FAQ

Are inactive ingredients the same for every manufacturer?
No. Inactive ingredients can differ by manufacturer, dosage form, strength, and package / product version.
Why might an inactive ingredient be missing?
Some SPLs do not provide a complete structured inactive-ingredient list, and older or unusual labels may only include the information in narrative text.
Can inactive ingredients matter?
Yes. They can matter for allergies, intolerances, dyes, gluten / lactose concerns, preservatives, and formulation differences — but confirm with a pharmacist or the manufacturer when it’s clinically important.

Manufacturer & labeler

LabelerAtlantis Consumer Healthcare, Inc.
Application holderXTTRIUM LABORATORIES INC
FDA applicationNDA019125 (NDA)
Labeler code67618
First marketedJun 1993
Product typeHuman Otc Drug
Portfolio17 products on file

More NDCs from Atlantis Consumer Healthcare, Inc. labeler code 67618

The labeler markets the product; the application holder owns the FDA approval. They’re often the same company but can differ (e.g. a repackager or an authorized generic). A mailing address / phone appears here when the manufacturer includes it in the product’s FDA label (not all do).
Where does this data come from?
Labeler, application holder and registered establishment from the FDA openFDA NDC Directory and Drugs@FDA; address/contact from the product’s FDA label.

FDA label — Drug Facts FDA SPL

The complete FDA label for this product — the official Drug Facts labeling, verbatim, section by section. Jump with a chip, search within the label, or expand everything.
🎯 Indications and Usage ⏱️ Dosage and Administration 💊 Dosage Forms and Strengths ⚠️ Warnings 🧪 Inactive Ingredients 🎯 Purpose 📋 Description 📄 Do Not Use 📄 When Using This Product 📄 Stop Use and Ask a Doctor If 📄 Keep Out of Reach of Children 📄 Other Information 📄 Package Label / Principal Display Panel
🎯 Indications and Usage 57 words ▾

Surgical hand scrub: wet hands and forearms with water scrub for 3 minutes with about 5 mL of product and a wetbrush, paying close attention to the nails, cuticles, and interdigitalspaces a separate nail cleaner may be used rinse thoroughly wash for an additional 3 minutes with 5 mL of product andrinse under running water dry thoroughly

⏱️ Dosage and Administration 27 words ▾

Healthcare personnelhandwash: wet hands with water dispense about 5 mL of product into cupped hands and washin a vigorous manner for 15 seconds rinse and dry thoroughly

💊 Dosage Forms and Strengths 34 words ▾

Skin wound and general skin cleansing: thoroughly rinse the area to be cleaned with water apply the minimum amount of product necessary to cover theskin or wound area and wash gently rinse again thoroughly

⚠️ Warnings 38 words ▾

Warnings For external use only Allergy alert: This product may cause a severe allergic reaction. Symptoms may include: wheezing/difficulty breathing Shock facial swelling hives rash. If an allergic reaction occurs, stop use and seek medical help right away.

🧪 Inactive Ingredients 66 words ▾

Inactive ingredients cocamide DEA, fragrance, glucono-delta-lactone, hydroxyethylcellulose, isopropyl alcohol, lauramine oxide, PEG-75 lanolin, purified water, tridecyl alcohol Questions or comments? call 1-888-827-0624 (8am-5pm, EST, Mon-Fri.) WARNING: This product can expose you to chemicals including coconut oil diethanolamine condensate (cocamide diethanolamine), which is known to the State of California to cause cancer. For more information go to www.P65Warnings.ca.gov Dist. by: Avrio Health L.P. Stamford, CT 06901-3431 304978-0A

🎯 Purpose 2 words ▾

Purpose Antiseptic

📋 Description 9 words ▾

Drug Facts Active ingredient Purpose Chlorhexidine gluconate 4% solution

📄 Do Not Use 27 words ▾

Do not use if you or the patient is allergic to chlorhexidine gluconateor any other ingredient in this product in contact with meninges in the genital area

📄 When Using This Product 119 words ▾

Uses surgical hand scrub: significantly reducesthe number of microorganisms on the hands and forearms prior to surgery or patient care healthcare personnel handwash: helps reducebacteria that potentially can cause disease skin wound and general skin cleansing

When using this product keep out of eyes, ears, and mouth. May cause serious andpermanent eye injury if permitted to enter and remain in the eye ormay cause deafness when instilled in the middle ear through perforatedeardrums. if solution should contact these areas, rinse out promptlyand thoroughly with water wounds which involve more than the superficial layers ofthe skin should not be routinely treated repeated general skin cleansing of large body areas shouldnot be done except when advised by a health care provider

📄 Stop Use and Ask a Doctor If 19 words ▾

Stop use and ask a doctor if irritation,sensitization, or allergic reaction occurs. These may be signs ofa serious condition.

📄 Keep Out of Reach of Children 18 words ▾

Keep out of reach of children . Ifswallowed, get medical help or contact a Poison Control Center rightaway.

📄 Other Information 34 words ▾

Directions use with care in premature infants or infants under 2 months of age. These products may cause irritation or chemical burns.

Other information store at 20-25°C (68-77°F) avoid excessive heat above 40°C (104°F)

📄 Package Label / Principal Display Panel 7 words ▾

BETASEPT Antiseptic Surgical Scrub NDC: 67618–200–30 304978-0A

Source: FDA Structured Product Labeling, mirrored from DailyMed / openFDA. Prefer the government’s original formatting? View this label on DailyMed ↗

Medicaid utilization & spend

📍 This exact package only: Medicaid data is reported per full 11-digit NDC — labeler, product and pack size — so every number here is for this package alone, not the drug overall. Other pack sizes report separately.
💊 Pharmacy benefit only: These are Medicaid outpatient pharmacy claims, billed by NDC. They exclude the medical benefit — clinic- or hospital-administered drugs billed under HCPCS J-codes — so drugs used mostly that way (e.g. Avastin, Lucentis, Keytruda) can look low or missing here. That’s expected, not an error.
📅 Q1 2025 – Q1 2026 · 5 quarters of data
ⓘ The newest quarter is usually incomplete when first published; states restate recent quarters in later CMS releases, so the latest figures typically revise upward. State coverage-policy changes can also shift quarter-to-quarter totals.
Prescriptions last 4 qtrs
729
Units reimbursed last 4 qtrs
421K
Gross reimbursed last 4 qtrs
$14.9K
Avg / prescription
$20.40
Avg / unit
$0.0353
Latest quarter Q1 2026
150Rx
Medicaid pays / mL
$0.0353
gross reimbursed
vs
NADAC / mL
$0.0178
acquisition cost
=
Spread
+$0.0175
+98% vs cost
What Medicaid paid per mL (before rebates; includes the pharmacy’s dispensing fee) compared with NADAC — the average price pharmacies pay to buy the drug. A positive spread means Medicaid reimbursed more than the purchase price, before manufacturer rebates.
Fee-for-service vs managed care ⓘ
30% FFS 70% MCO
Fee-for-service · 220 Rx Managed care · 509 Rx
State Medicaid map
Alaska: no data reported AK Maine: no data reported ME Washington: no data reported WA Idaho: no data reported ID Montana: no data reported MT North Dakota: no data reported ND Minnesota: 26,488 units · 462 per 100k residents MN Wisconsin: no data reported WI Michigan: no data reported MI New York: no data reported NY Vermont: 55,341 units · 8,553 per 100k residents VT New Hampshire: no data reported NH Oregon: no data reported OR Nevada: no data reported NV Wyoming: no data reported WY South Dakota: no data reported SD Iowa: no data reported IA Illinois: no data reported IL Indiana: no data reported IN Ohio: 236,500 units · 2,007 per 100k residents OH Pennsylvania: no data reported PA New Jersey: no data reported NJ Massachusetts: no data reported MA California: no data reported CA Utah: no data reported UT Colorado: no data reported CO Nebraska: no data reported NE Missouri: no data reported MO Kentucky: 51,557 units · 1,139 per 100k residents KY West Virginia: no data reported WV Virginia: no data reported VA Maryland: no data reported MD Connecticut: no data reported CT Rhode Island: no data reported RI Arizona: no data reported AZ New Mexico: no data reported NM Kansas: no data reported KS Arkansas: no data reported AR Tennessee: no data reported TN North Carolina: no data reported NC South Carolina: 51,084 units · 951 per 100k residents SC Delaware: no data reported DE Oklahoma: no data reported OK Louisiana: no data reported LA Mississippi: no data reported MS Alabama: no data reported AL Georgia: no data reported GA D.C.: no data reported DC Hawaii: no data reported HI Texas: no data reported TX Florida: no data reported FL
Units reimbursed · per 100k residents
4628,553
gray = no data reported ⓘ
Colors are per 100,000 residents, so big states don’t automatically dominate. Tap or hover a state for its actual totals.
Tap or hover a state
…for its Medicaid breakdown
🏆 Top states by units · per 100k residents
1 Vermont 8,553 /100k
2 Ohio 2,007 /100k
3 Kentucky 1,139 /100k
4 South Carolina 951 /100k
5 Minnesota 462 /100k
National units — by quarter
💵 About the dollar figures: “reimbursed” is what Medicaid paid pharmacies before confidential manufacturer rebates, so the program’s real net cost is lower than these numbers. Fee-for-service and managed-care claims are combined unless split above. Source: CMS State Drug Utilization Data; per-100k rates use 2023 Census population estimates.

Medicaid utilization by pack size

Medicaid (SDUD) totals over the four most recent reported quarters for every package size of this drug — handy when a specific package (e.g. a starter/titration pack) carries little or no Medicaid volume on its own.
237 ml67618-0200-08 1,002 Rx · $14,842
473 ml this page67618-0200-16 729 Rx · $14,874
118 ml67618-0200-04 532 Rx · $6,711
946 ml67618-0200-30 246 Rx · $7,740
946 ml67618-0200-32 No Medicaid data
Drug total (last 4 qtrs): 2,509 Rx · 1,114,349 units · $44,166 gross reimbursed
Tap a pack size to open its page. Source: CMS State Drug Utilization Data, last 4 quarters.
← 67618-0192-03 · Atlantis 67618-0201-12 · Atlantis →
For educational and professional reference only — not medical advice. Pricing reflects published NADAC and CMS ASP (free public data) and may differ from your acquisition cost; always verify before billing or dispensing.