Home › NDC Lookup › Ingredients › Codeine Phosphate And Guaifenesin › 69367-0272-16
Codeine-Guaifenesin 10 mg/5mL; 100 mg/5mL Solution, 473 mL — NDC 69367-0272-16 package photo
Label image from the product's FDA listing (DailyMed) — may show a different pack size or an older label revision.

Codeine-Guaifenesin 10 mg/5mL; 100 mg/5mL Solution, 473 mL — NDC 69367-272-16 (Billing 69367-0272-16)

by Westminster Pharmaceuticals, LLC · 473 mL in 1 BOTTLE

This is a package of 473 mL of Codeine-Guaifenesin 10 mg/5mL; 100 mg/5mL Solution from Westminster Pharmaceuticals, LLC, marketed since Jul 2020 and currently FDA-listed; retail pharmacies pay about $0.0327 per mL (NADAC). It is the main listing for this product, which comes in 2 package sizes.

NDC 69367-0272-16
🏷️ FDA NDC (as labeled) 69367-272-16 billing pads the product segment with a zero
This package
Contains473 mL Cost per mL$0.0327 NADAC Per package$15.47 / 473 ml Pack sizes2 compare ↓
Also priced by: Medicaid pays $0.0781/unit — full pricing hub ↓
Main listing for product 69367-272 · Also comes in: 118 ml 69367-272-04
OTC On market CV ⇄ 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

Identity & classification

Regulatory identifiers FDA, NLM and CMS codes for this package

FDA NDC (as labeled) 69367-272-16
Product NDC 69367-272
11-digit billing NDC 69367027216
NCPDP billing unit ML — per mL (volume)
RxCUI 995868
UNII GSL05Y1MN6, 495W7451VQ
UPC 0369367272162
Application # M012
SPL Set ID 3da3efd7-e278-4d79-9130-eef3992097e4
Established class (EPC) Expectorant
Physiologic effect Decreased Respiratory Secretion Viscosity; Increased Respiratory Secretions
DEA schedule CV
Marketing category OTC MONOGRAPH DRUG
Marketing status On market
FDA listing status Listed (active directory)
Marketing start 2020-07-15
Route ORAL
Dosage form SOLUTION
Substance CODEINE PHOSPHATE; GUAIFENESIN

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

GPI-14 43997002282020
GPI class guaiFENesin-Codeine
GCN Seq No 045669
GCN 91713
HICL code 000206
Ingredient (HICL) Codeine Phosphate/Guaifenesin
HIC1 code B
Therapeutic class — broad (HIC1) Respiratory System
HIC2 code B4
Therapeutic class — intermediate (HIC2) Drugs Affecting The Trachea And Bronchi (Contin.1)
HIC3 code B4S
Therapeutic class — specific (HIC3) Opioid Antitussive-Expectorant Combination
AHFS code 28:08.08.00
AHFS class Opioid Agonists (28:08)
FDB label name CODEINE-GUAIFEN 10-100 MG/5 ML
FDB brand name Codeine-Guaifenesin
Legend status O — Over-the-counter (OTC) drug or device
Quick answers
  • GSN (GCN sequence number): 045669
  • GCN: 91713
  • GPI-14 (Medi-Span): 43997002282020
  • HICL (First Databank): 000206
  • AHFS class code: 28:08.08.00
  • RxCUI (RxNorm): 995868
Why two NDCs? The FDA registers this code as 69367-272-16 — 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 → 69367-0272-16. 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 Opioid Agonist class.

Pharmacologic class Opioid Agonist
Drug family (ATC) Opium alkaloids and derivatives
How it works Full Opioid Agonists
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 CODEINE-GUAIFEN 10-100 MG/5 ML Ingredient Codeine Phosphate/Guaifenesin
🧪 What is this product?

This is an oral solution containing codeine phosphate and guaifenesin, marketed as an OTC monograph cough and cold product. Codeine is a cough suppressant typically used to reduce cough reflex, while guaifenesin functions as an expectorant commonly used to help thin and loosen mucus. This combination formulation is intended for oral use to address cough symptoms associated with minor respiratory conditions.

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 $0.033 $15.47 / 473 ml
Medicaid paysCMS SDUD · 12 mo $0.0781 $36.94 / 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
Jan 2022 Aug 2022 Jan 2026 Sep 2026 $0.037 $0.025
▲ Up 30% over the last 24 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
69367-0272-04 69367-272-04 118 mL in 1 BOTTLE $0.0645 / mL $7.61 2020-07-15 — Active
69367-0272-16 You're viewing this Main listing 473 mL in 1 BOTTLE $0.0327 / mL $15.47 2020-07-15 — Active

You're viewing the largest of 2 pack sizes for this product.

This pack has the lowest per-mL cost of the 2 priced pack sizes ($0.0327 NADAC).

In Medicaid, this is the most-dispensed pack of this product — about 83% of fills over the last four reported quarters. 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 69367-0272-04?
Both are Codeine-Guaifenesin 10 mg/5mL; 100 mg/5mL Solution — the drug itself is identical. This page's package is the 473 mL one, while NDC 69367-0272-04 is the 118 ml package. Per-mL NADAC also differs: $0.0327 here vs $0.0645 for the 118 ml pack.
What NDC number is used to bill for this package of Codeine-Guaifenesin 10 mg/5mL; 100 mg/5mL 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
Codeine-Guaifenesin 10 mg/5mL; 100 mg/5mLthis 69367-0272-16 Westminster 473 ml $0.033 — Availability likely —
Codeine-Guaifenesin 10 mg/5mL; 100 mg/5mL 58657-0500-04 Method 120 ml $0.059 — Availability likely +80%
Guaifenesin and Codeine Phosphate 100 mg/5mL; 10 mg/5mL 00121-0775-04 PAI 118 ml $0.064 — Availability likely +97%
Guaifenesin and Codeine Phosphate 200 mg/10mL; 20 mg/10mL 00121-1550-00 PAI 10 cups — — FDA listed —
Guaifenesin and Codeine Phosphate 100 mg/5mL; 10 mg/5mL 00121-1775-00 PAI 10 cups — — FDA listed —
Guaifenesin and Codeine Phosphate 100 mg/5mL; 10 mg/5mL 50090-1428-00 A-S 118 ml — — FDA listed —
Codeine-Guaifenesin 10 mg/5mL; 100 mg/5mL 50090-6435-00 A-S 118 ml — — FDA listed —
Guaifenesin and Codeine Phosphate 10 mg/5mL; 100 mg/5mL 55154-5791-05 Cardinal 5 cups — — FDA listed —
Codeine-Guaifenesin 10 mg/5mL; 100 mg/5mL 68071-5173-04 NuCare 120 ml — — FDA listed —
Guaifenesin and Codeine Phosphate 100 mg/5mL; 10 mg/5mL 68788-8361-01 Preferred 118 ml — — FDA listed —
Codeine-Guaifenesin 10 mg/5mL; 100 mg/5mL 71205-0624-04 Proficient 118 ml — — FDA listed —
Codeine-Guaifenesin 10 mg/5mL; 100 mg/5mL 72162-1669-02 Bryant 120 ml — — FDA listed —
About this product: other versions of the same ingredient, strength and form are listed above, least expensive first, with FDA equivalence ratings where available.
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

🏛️
2020
On the market since
Jul 2020
📍
2026
Currently FDA-listed
6 years listed
🔒
·
No generic listed yet
brand only
ℹ️No FDA-approved generic found

We did not find an FDA-approved generic match for this exact strength, form and route.

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.

What it looks like

FlavorCherry
One label can cover several strengths, so colors may be combined — always confirm a loose pill against the dispensed prescription label or a pharmacist.
Where does this data come from?
Physical description (imprint, shape, color, scoring, coating) from this product’s FDA Structured Product Labeling (SPL), mirrored from DailyMed / openFDA.

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 2968PHW8QP
    A weak organic acid derived from citrus fruits or made through fermentation. It works as a buffer to control pH, a preservative to extend shelf life, and a flavoring agent in medications.
  • UNII A2I8C7HI9T
    Methylparaben is a preservative derived from benzoic acid that prevents growth of bacteria, fungi, and mold in medicines. It extends the product's shelf life and maintains safety during storage.
  • UNII EE90ONI6FF
    Potassium citrate is a salt derived from citric acid and potassium. In medicines, it acts as a buffer to adjust and maintain the pH balance of the product, helping keep it stable and palatable.
  • UNII 1VPU26JZZ4
    Potassium sorbate is a salt derived from sorbic acid, a naturally occurring preservative. It prevents growth of mold, yeast, and some bacteria, extending the medicine's shelf life.
  • UNII 6DC9Q167V3
    Propylene glycol is a clear liquid derived from petroleum or vegetable sources. It acts as a solvent, humectant, and preservative in medicines, helping dissolve active ingredients and maintain product stability.
  • UNII Z8IX2SC1OH
    Propylparaben is a chemical preservative used to prevent bacterial and fungal growth in medicines and personal care products. It helps extend shelf life and maintain product safety during storage.
  • UNII 506T60A25R
    Sorbitol is a natural sugar alcohol derived from glucose. It serves as a sweetener, humectant, and bulking agent in medications to improve taste and help maintain moisture in the product.
  • UNII 96K6UQ3ZD4
    Sucralose is a synthetic sweetener made from sugar. It's added to medicines to improve taste without adding calories, helping make bitter or unpleasant-tasting drugs easier to take.
  • 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.

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

The official label also statesCherry flavor, citric acid, methylparaben, potassium citrate, potassium sorbate, propylparaben, propylene glycol, purified water, sorbitol, sucralose.

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

LabelerWestminster Pharmaceuticals, LLC
FDA applicationM012 (OTC MONOGRAPH DRUG)
Labeler code69367
First marketedJul 2020
DEA scheduleCV
Product typeHuman Otc Drug
Portfolio186 products on file
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 ⚠️ Warnings 📦 Storage and Handling 🧪 Active Ingredient 🧪 Inactive Ingredients 🎯 Purpose 📄 Ask a Doctor Before Use If 📄 When Using This Product 📄 Stop Use and Ask a Doctor If 🤰 If Pregnant or Breast-Feeding 📄 Keep Out of Reach of Children 📄 Package Label / Principal Display Panel
🎯 Indications and Usage 47 words ▾

Uses temporarily relieves: cough due to minor throat and bronchial irritation as may occur with a cold or inhaled irritants your cough to help you sleep helps loosen phlegm (mucus) and thin bronchial secretions to rid the bronchial passageways of bothersome mucus and make coughs more productive.

⏱️ Dosage and Administration 61 words ▾

Directions do not exceed 6 doses in 24 hours. Adults and children 12 years of age and over: 2 tsp (10 mL) every 4 hours, or as directed by a doctor. Children 6 to under 12 years of age: 1 tsp (5 mL) every 4 hours, or as directed by a doctor. Children under 6 years of age: Consult a doctor.

⚠️ Warnings 181 words ▾

Warnings Ask your doctor before use if you have a persistent cough, this may be a sign of a serious condition you have a persistent cough such as occurs with smoking, asthma, chronic bronchitis or emphysema you have a cough that is accompanied by excessive phlegm (mucus) you have chronic pulmonary disease or shortness of breath giving to a child who is taking other drugs When using this product giving a higher dose than recommended by a doctor could result in serious side effects for your child. A special measuring device should be used to give an accurate dose of this product to children under 6 years of age. may cause or aggravate constipation Stop use and ask a doctor if symptoms do not improve within 7 days, tend to recur or are accompanied by fever and rash or persistent headache.

These may be symptoms of a serious condition. If pregnant or breast-feeding, ask a health professional before use. Keep out of the reach of children.

In case of overdose, get medical help or contact a Poison Control Center right away.

📦 Storage and Handling 21 words ▾

Other information Store at controlled room temperature 15°-30°C (59°-86°F). You may report side effects by calling 1-844-221-7294 or FDA at 1-800-FDA-1088.

🧪 Active Ingredient 21 words ▾

Active ingredients (in each 5 mL = 1 tsp) Purpose Codeine phosphate, USP 10 mg Antitussive Guaifenesin, USP 100 mg Expectorant

🧪 Inactive Ingredients 18 words ▾

Inactive Ingredients Cherry flavor, citric acid, methylparaben, potassium citrate, potassium sorbate, propylparaben, propylene glycol, purified water, sorbitol, sucralose.

🎯 Purpose 21 words ▾

Active ingredients (in each 5 mL = 1 tsp) Purpose Codeine phosphate, USP 10 mg Antitussive Guaifenesin, USP 100 mg Expectorant

📄 Ask a Doctor Before Use If 64 words ▾

Ask your doctor before use if you have a persistent cough, this may be a sign of a serious condition you have a persistent cough such as occurs with smoking, asthma, chronic bronchitis or emphysema you have a cough that is accompanied by excessive phlegm (mucus) you have chronic pulmonary disease or shortness of breath giving to a child who is taking other drugs

📄 When Using This Product 49 words ▾

When using this product giving a higher dose than recommended by a doctor could result in serious side effects for your child. A special measuring device should be used to give an accurate dose of this product to children under 6 years of age. may cause or aggravate constipation

📄 Stop Use and Ask a Doctor If 35 words ▾

Stop use and ask a doctor if symptoms do not improve within 7 days, tend to recur or are accompanied by fever and rash or persistent headache. These may be symptoms of a serious condition.

🤰 If Pregnant or Breast-Feeding 10 words ▾

If pregnant or breast-feeding, ask a health professional before use.

📄 Keep Out of Reach of Children 22 words ▾

Keep out of the reach of children. In case of overdose, get medical help or contact a Poison Control Center right away.

📄 Package Label / Principal Display Panel 75 words ▾

PRINCIPAL DISPLAY PANEL - 473 mL Bottle Label NDC 69367-272-16 Codeine- Guaifenesin Oral Solution 10-100 mg/5 mL Antitussive/Expectorant Sugar Free, Alcohol Free, Dye Free Each 5 mL (1 teaspoonful) contains: Codeine phosphate, USP 10 mg Guaifenesin, USP 100 mg (WARNING: May be habit-forming) Tamper evident by foil seal under cap. Do not use if foil seal is broken or missing. 16 fl. oz.

(473 mL) Westminster Pharmaceuticals PRINCIPAL DISPLAY PANEL - 473 mL Bottle Label

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
40.4K
Units reimbursed last 4 qtrs
6.5M
Gross reimbursed last 4 qtrs
$506.3K
Avg / prescription
$12.54
Avg / unit
$0.0781
Latest quarter Q1 2026
13.4KRx
Medicaid pays / mL
$0.0781
gross reimbursed
vs
NADAC / mL
$0.0327
acquisition cost
=
Spread
+$0.0454
+139% 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 ⓘ
49% FFS 51% MCO
Fee-for-service · 19,817 Rx Managed care · 20,556 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: 77,403 units · 6,838 per 100k residents MT North Dakota: 13,225 units · 1,689 per 100k residents ND Minnesota: 365,571 units · 6,372 per 100k residents MN Wisconsin: 352,502 units · 5,965 per 100k residents WI Michigan: 34,474 units · 343 per 100k residents MI New York: no data reported NY Vermont: 66,085 units · 10,214 per 100k residents VT New Hampshire: 17,813 units · 1,271 per 100k residents NH Oregon: 208,050 units · 4,915 per 100k residents OR Nevada: 26,394 units · 826 per 100k residents NV Wyoming: 17,319 units · 2,966 per 100k residents WY South Dakota: 15,058 units · 1,639 per 100k residents SD Iowa: no data reported IA Illinois: 563,484 units · 4,490 per 100k residents IL Indiana: 71,941 units · 1,048 per 100k residents IN Ohio: 200,220 units · 1,699 per 100k residents OH Pennsylvania: 125,377 units · 967 per 100k residents PA New Jersey: 20,727 units · 223 per 100k residents NJ Massachusetts: no data reported MA California: 2,378,440 units · 6,104 per 100k residents CA Utah: 46,416 units · 1,358 per 100k residents UT Colorado: 23,804 units · 405 per 100k residents CO Nebraska: 3,992 units · 202 per 100k residents NE Missouri: 168,559 units · 2,720 per 100k residents MO Kentucky: 92,232 units · 2,038 per 100k residents KY West Virginia: no data reported WV Virginia: 280,467 units · 3,218 per 100k residents VA Maryland: 139,673 units · 2,260 per 100k residents MD Connecticut: 105,239 units · 2,910 per 100k residents CT Rhode Island: 39,690 units · 3,625 per 100k residents RI Arizona: 232,164 units · 3,124 per 100k residents AZ New Mexico: 98,678 units · 4,668 per 100k residents NM Kansas: no data reported KS Arkansas: 3,700 units · 121 per 100k residents AR Tennessee: no data reported TN North Carolina: no data reported NC South Carolina: 48,820 units · 909 per 100k residents SC Delaware: 7,001 units · 679 per 100k residents DE Oklahoma: no data reported OK Louisiana: 1,742 units · 38.1 per 100k residents LA Mississippi: 78,093 units · 2,656 per 100k residents MS Alabama: no data reported AL Georgia: 37,267 units · 338 per 100k residents GA D.C.: 3,220 units · 474 per 100k residents DC Hawaii: 104,327 units · 7,270 per 100k residents HI Texas: 400,450 units · 1,313 per 100k residents TX Florida: no data reported FL
Units reimbursed · per 100k residents
38.110,214
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 10,214 /100k
2 Hawaii 7,270 /100k
3 Montana 6,838 /100k
4 Minnesota 6,372 /100k
5 California 6,104 /100k
6 Wisconsin 5,965 /100k
7 Oregon 4,915 /100k
8 New Mexico 4,668 /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.
473 ml this page69367-0272-16 40,373 Rx · $506,277
118 ml69367-0272-04 8,211 Rx · $134,264
Drug total (last 4 qtrs): 48,584 Rx · 7,502,480 units · $640,540 gross reimbursed
Tap a pack size to open its page. Source: CMS State Drug Utilization Data, last 4 quarters.
← 69367-0266-01 · Westminster 69367-0287-05 · Westminster →
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.